Cephalohematomas are traumatic subperiosteal hematomas of the skull that are usually caused by birth injury. They are bound between the periosteum and cranium, and therefore cannot cross sutures. Being bound by a suture line distinguishes them from subgaleal hematoma, which can cross sutures.
Cephalohematomas occur in 1-2% of live births. The incidence increases with ventouse and forceps extraction and thus more common in primiparous mothers. There may be a greater male predilection 4.
Cephalohematomas are clinically diagnosed and infrequently imaged. They can be unilateral or bilateral, and appear as subgaleal fluid collections bounded by suture lines. In the setting of craniosynostosis, the blood products are able to traverse the affected suture 5. By 2-3 weeks, they may become peripherally calcified 5. The hematoma usually resolves in 2-3 months.
- separation of the scalp by subperiosteal hemorrhage of moderate echogenicity 5
- underlying brain is usually normal 5
Treatment and prognosis
Most resolve spontaneously.
- 1. Winter TC, Mack LA, Cyr DR. Prenatal sonographic diagnosis of scalp edema/cephalohematoma mimicking an encephalocele. AJR Am J Roentgenol. 1993;161 (6): 1247-8. AJR Am J Roentgenol (citation) - Pubmed citation
- 2. Rooks VJ, Eaton JP, Ruess L et-al. Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants. AJNR Am J Neuroradiol. 2008;29 (6): 1082-9. doi:10.3174/ajnr.A1004 - Pubmed citation
- 3. Ingram MD, Hamilton WM. Cephalohematoma in the newborn. (1950) Radiology. 55 (4): 502-7. Pubmed
- 4. Glass RB, Fernbach SK, Norton KI et-al. The infant skull: a vault of information. Radiographics. 24 (2): 507-22. doi:10.1148/rg.242035105 - Pubmed citation
- 5. Bansal AG, Oudsema R, Masseaux JA, Rosenberg HK. US of Pediatric Superficial Masses of the Head and Neck. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (4): 1239-1263. doi:10.1148/rg.2018170165 - Pubmed