A cephalohematoma is noted in ∼1%–2% of spontaneous vaginal deliveries and ∼3%–4% of forceps or vacuum-assisted deliveries.

The most common location is under the right parietal bone and may be associated with an underlying skull fracture. Resolution typically occurs without treatment by 3–4 months of age. Anemia and hyperbilirubinemia are common sequelae, but cephalohematomas rarely become spontaneously infected.

In 2013 there was the first report describing a possible association between parvovirus B19 infection and cephalhematoma. Parvovirus B19 infection should be considered in the differential diagnosis of children who present with unexplained hemorrhage such as cephalhematoma or petechiae 1).

Subgaleal hematoma

Subperiosteal hematoma

see also Spontaneous subaponeurotic fluid collection

Right frontotemporoparietal intracranial acute epidural hematoma, up to 1 cm. thick, underlying a broad line of right temporoparietal Right parietal subgaleal hematoma, up to 1cm. of thickness.

Hemorrhage under the scalp

Not to confuse with subperiosteal hematoma.

Surgical drainage of uncomplicated cephalohematomas is contraindicated because of the usually benign course, the propensity for reaccumulation with resultant hemodynamic instability, and the possibility of introducing microorganisms into a sterile space.

Anemia and hyperbilirubinemia.

Calcified cephalhematoma


Clinicians should be aware that cephalohematoma is a potential site of infection after fetal monitoring.

The incidence of associated system infection is high and may result in mortality. Appropriate diagnostic and therapeutic measures should be undertaken promptly if there are infectious signs 2).

A 30-day-old infant presenting a E. coli meningitis with recurrence 5 days after stopping antibiotics. The clinical investigations concluded to the diagnosis of osteomyelitis of the parietal bone probably as a consequence of the infection of a cephalohematoma due to a wound caused by a foetal monitoring. Cephalohematoma is frequent in infant and is usually without consequences. Though rare, cases of infected cephalohematomas are described in the literature, with possible complications of meningitis (E. coli) and osteomyelitis. Sometimes the both pathologies are associated. A secondary infection of cephalohematomas must be taken in consideration when the etiology of a E. coli meningitis is not quite clear enough. In this situation, looking for an osteomyelitis whose presence may influence the infant's treatment is needed. 3).

A subgaleal hematoma is an accumulation of blood within the loose connective tissue of the subgaleal space, which is located between the galea aponeurotica and the periosteum

Unlike a cephalohematoma, a subgaleal hematoma can be massive, leading to profound hypovolemic shock.

Takeuchi M, Shiozawa R, Hangai M, Takita J, Kitanaka S. Cephalhematoma and petechial rashes associated with acute parvovirus B19 infection: a case report. BMC Infect Dis. 2013 Oct 7;13:465. doi: 10.1186/1471-2334-13-465. PubMed PMID: 24093148; PubMed Central PMCID: PMC3851625.
Chang HY, Chiu NC, Huang FY, Kao HA, Hsu CH, Hung HY. Infected cephalohematoma of newborns: experience in a medical center in Taiwan. Pediatr Int. 2005 Jun;47(3):274-7. PubMed PMID: 15910450.
Van Helleputte C, Dupont V, Barthels S, Aeby A. [Escherichia coli meningitis and parietal osteomyelitis in an infant: a rare complication of cephalohematoma]. Rev Med Brux. 2010 Jan-Feb;31(1):57-9. French. PubMed PMID: 20384053.
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