Spot Diagnosis

Cephalhematoma

Neeraj Awasthy, Karam Chand
Department of Pediatrics, Neurosurgery, Safdarjung Hospital, Delhi

Address for Correspondence: Dr Neeraj Awasthy, 123, Nandkunj, Vikaspuri, New Delhi 10018, India.
Email: n_awasthy@yahoo.com
Question :
A 54 days old male born to a 22-year-old booked primigravida by normal vaginal delivery at 38 weeks of gestation presented with swelling over the right parietal region since birth. General physical examination revealed 5x2.5 cm right parietal mass, hard in consistency fixed to the underlying bone. Hemogram and LFT were normal. CT examination is shown in the image.



What is the diagnosis?

Discussion :
CT examination of the skull revealed 5 x 2.5 cm sized hypodense extracalvarial lesion with a thick calcified rim in the right parietal region suggestive of a cephalhematoma. Cephalhematomas are confined sharply by the edges of the bone. These are usually localized over the parietal and the occipital bones. The radiological appearance varies with the age of the lesion. It is made up of blood during the first 2 weeks. Near the end of the second week, bone formation starts, initially at the margin of the cephalhematoma soon to overlay with a complete shell of the bone at the periphery. Depending upon their size cephalhematomas are gradually absorbed from 2 weeks to 3 months. Associated underlying fractures may accompany the lesion. Some of the lesions may be replaced by the normal diploic bone. It may persist as small cyst like defects for months or may persist into adult life as cephalhematoma deformans.

E-published:

Correct Answers : yes  57%

Last Shown : Jun 2005
 
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