Imaging Case

• Main Authors: Maria Adriana Rangel, Graça Loureiro, Mariana Pinto
• Format: Article
• Language: English
• Published: Centro Hospitalar do Porto 2018-04-01
• Series: Nascer e Crescer
• Subjects: Birth Injuries; calcified cephalohematoma; newborn
• Online Access: http://revistas.rcaap.pt/nascercrescer/article/view/13012

Introduction: Cephalohematoma is a collection of serosanguineous fluid below the periosteum and is the most frequent cranial injury in the newborn, occurring in 0.2-2.5% live births. The majority of cephalohematomas spontaneously resolve within three to four weeks, however, some persist beyond four weeks and begin to calcify. Case report: A seven-week-old boy, was referred to the emergency department because of a head lump on the right parietal region, with no other symptoms. He was born after a vacuum-assisted delivery, and presented a cephalohematoma in the first days of life, that progressively decreased and became more rigid. Physical examination, revealed a cranial asymmetry, and a head lump on the right parietal region, that was hard and fixed to the bone. Head X-ray revealed a radiopaque lump on the right parietal bone and a poorly defined arched line, as well as visible microcalcifications on the core of the cephalohematoma, typical findings of a calcified cephalohematoma. Discussion: Even though cephalohematoma is frequently encountered, calcified cephalohematoma is seen only sporadically, and is a rare clinical entity. History and clinical examination are important in the differential diagnosis and imaging strategy. Radiography and ultrasonography are often the initial screening diagnostic tests, followed by magnetic resonance imaging or computed tomography. Head x-ray features, in this case report, where particularly evocative of the diagnosis.