II. Epidemiology

  1. Incidence: 0.2 to 2.5% of live births

III. Causes

  1. Prolonged labor
  2. Instrumented delivery (e.g. forceps)

IV. Pathophysiology

  1. Rupture of blood vessels between skull and periosteum
  2. Results in subperiosteal blood collection
  3. Bleeding limited by Suture lines

V. Signs

  1. Cephalhematoma does not cross Suture lines
  2. Well-demarcated, fluctuant swelling
  3. Most commonly occurs over Parietal Bone
  4. No overlying Skin Discoloration
  5. Appears by day 2-3 of life

VI. Differential Diagnosis

  1. Cranial Meningocele (Occipital Cephalhematoma)
    1. Pulsates, and increased pressure on crying

VII. Associated Conditions

  1. Linear Skull Fracture (occurs in 5 to 20% of cases)
    1. See Skull Fracture from Birth Trauma

IX. Radiology

  1. Indications for Skull XRay or CT Head
    1. CNS signs
    2. Large Cephalhematoma
    3. Difficult delivery
  2. Findings
    1. Tangential view of Cephalhematoma
      1. Homogenous soft tissue density
      2. Sharply demarcated convex outer border
      3. Over time border develops fine calcified rim
    2. Skull Fracture may be associated finding
      1. See Skull Fracture from Birth Trauma

X. Course

  1. Resolves over 2 weeks to 3 months
  2. Residual calcification may occur in 1% of cases

XI. Management

  1. Observation in uncomplicated cases
  2. Significant blood accumulation therapy
    1. Transfusion
    2. Phototherapy
  3. Fracture
    1. See Skull Fracture from Birth Trauma

XII. References

  1. Gabbe (1996) Obstetrics, Churchill-Livingstone, p.661-2
  2. Behrman (2000) Nelson Pediatrics, Saunders, p. 489
  3. Weintraub (2000) Otolaryngol Clin North Am 33:1171-89

Images: Related links to external sites (from Google)

Ontology: Cephalhematoma due to birth trauma (C0007722)

Definition (NCI) A subperiosteal hemorrhage limited to the surface of one cranial bone, a usually benign condition seen in the newborn as a result of bone trauma.
Definition (NCI) A subperiosteal hemorrhage limited to the surface of one cranial bone, a usually benign condition seen in the newborn as a result of bone trauma.
Concepts Injury or Poisoning (T037)
ICD10 P12.0
SnomedCT 83095000, 206200000
English Fetal cephalhaematoma, Fetal cephalohaematoma, Cephalhaematoma due to birth injury, Cephalhematoma due to birth injury, Foetal cephalohaematoma, cephalohematoma (diagnosis), cephalohematoma, Cephalhematoma due to birth trauma, Foetal cephalhaematoma, CEPHALOHEMATOMA, cephalohaematoma, Cephalohematoma, Fetal cephalhematoma, Cephalohaematoma, Cephalhaematoma, Cephalhaematoma due to birth trauma, Cephalhematoma, Cephalhematoma due to birth trauma (disorder), Fetal cephalhematoma (disorder), cephalhaematoma, cephalhematoma
Italian Cefaloematoma
French Céphalohématome, Céphalhématome
Portuguese Cefaloematoma, Cefalematoma
Japanese 頭血腫, トウケッシュ
German Kephalhaematom durch Geburtsverletzung, Kephalhaematom
Czech Cefalohematom, Kefalohematom
Korean 출산 손상으로 인한 머리혈종
Hungarian Cephalohaematoma, Cephalhaematoma
Dutch Cefaalhematoom door geboortetrauma, cefaalhematoom
Spanish cefalohematoma fetal (trastorno), cefalohematoma fetal, cefalohematoma por traumatismo obstétrico (trastorno), cefalohematoma por traumatismo obstétrico, cefalohematoma, Cefalohematoma