What is a cephalhematoma?
The cephalhematoma, or also called “hematoma of the head“, is a bruise that occurs in connection with an injury to the infant at birth. It causes vascular injuries to the back of the baby’s head as a result of shear forces during the birth process. The cephalhematoma is defined as such by the fact that it is located directly above the skull bone and below the associated periosteum, which gives it a typical bulging elastic consistency. This location also prevents the bruise from extending beyond the limits of the skull bone and defines the cephalhematoma
Causes
Cephalhematoma is caused by shear forces between the bones of the skull, which typically occur during childbirth. In this context, so-called “suture diastases” occur frequently, i.e. the skull bones slide apart, and skull fractures occur. In both cases, vessels between the bones of the skull and between the bones and periosteum are often injured.
The resulting bleeding accumulates between the bone itself and its periosteum and causes a bouncy, elastic bruise that does not spread beyond the boundaries of the affected skull bone. Such hematomas are often caused by a so-called “forceps delivery”. This is a delivery which should be facilitated with the help of forceps. In the process, uneven pressure is exerted on the child’s head, which promotes a cephalic hematoma.
Diagnosis
The diagnosis is largely determined by the characteristics of the cephalhematoma and how it presents. These include its bulging elastic consistency, which is due to the fact that blood collects between the skull bone and its taut periosteum. It also results in its pattern of expansion, which does not extend beyond the boundaries of the skull bone.
Sonography is also used to diagnose cephalhematoma. It should provide information about the exact location of the bruise and where it extends. The brain and skull bones are also assessed to rule out further injuries. If, however, there is a suspicion of a fracture of the skull, further imaging examination methods are required, such as an MRI, in order to better visualize the possible fracture.
