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Cephalohematoma, is this something to worry about?



 
 
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  #1  
Old December 9th 06, 12:38 AM posted to misc.kids.pregnancy
concerned
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Posts: 1
Default Cephalohematoma, is this something to worry about?

I asked several nurses in the hospital and also our brand new
pediatrician about a soft squishy area on my newbord daughter's head.
They all assured me that it is a Cephalohematoma and nothing to worry
about. I asked again at the 5 day checkup at the pediatrican's office
and again 'it will go away'. She is 11 days old now and the puffy area
seems to have gotten larger.(or maybe I'm just obsessing over it making
it look larger to me??) I don't know if i'm worrying over nothing or if I
need to take her to the hospital to get checked out before next week's
pediatrician appointment in 5 days.

Anybody have any experience with these? The puffyest part is just off
to the right of the crown of the head(towards the top/back) and
circumference about the size of a silver dollar.

  #2  
Old December 9th 06, 01:37 AM posted to misc.kids.pregnancy
Pologirl
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Posts: 342
Default Cephalohematoma, is this something to worry about?


concerned wrote:
They all assured me that it is a Cephalohematoma and nothing to worry
about.


Welcome to parenthood. Worrying is normal, especially since you don't
yet know where to go for good information. One source I like is the US
National Library of Medicine, their search page for the general public
provides links to high quality information. Such as:

http://kidshealth.org/parent/pregnan...ariations.html

A cephalohematoma is a collection of blood that has seeped under the
outer covering membrane of one of the skull bones. This is usually
caused during birth by the pressure of the head against the mother's
pelvic bones. The lump is confined to one side of the top of the baby's
head and, in contrast to caput succedaneum, may take a week or two to
disappear. The breakdown of the blood collected in a cephalohematoma
may cause these infants to become somewhat more jaundiced than others
during the first week of life. It's important to remember that both
caput succedaneum and cephalohematoma occur due to trauma outside of
the skull - neither indicates that there has been any injury to the
infant's brain.

  #3  
Old December 9th 06, 02:16 AM posted to misc.kids.pregnancy
Jamie Clark
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Posts: 855
Default Cephalohematoma, is this something to worry about?

Concerned,
Below is text that I found Googling Cephalohematoma. Basically, it's a
bruise under the dura matter of the scalp. The important things to know
from the article are the following --

"Obviously, there is no treatment necessary or ever warranted for an
uncomplicated cephalohematoma. By no means should they ever be drained or
needled, because of the risk of introducing infection into the space."

I'd also take into serious consideration, during this or any childhood
illness, accident, or worry, how your doctors are acting about the issue and
what they say. I've learned from personal experience that if doctors think
that you or your child is in serious danger, you'll know because they will
be booking you into the hospital, or telling you to come back as soon as
possible for more testing. If a doctor says, "oh, that's just a blah blah
blah, and it's nothing to worry about, and will go away on it's own" that
pretty much means that it's nothing to worry about and it will go away on
it's own. Especially if you've now asked more than twice about it, and were
told the same thing by multiple people.

http://www.drhull.com/EncyMaster/C/cephalohematoma.html

Cephalohematoma
There is a very tough tissue covering that encapsulates bones, called the
dura mater (DOO-rah MATE-er). It adheres tenaciously to the outer and inner
surfaces of all the bones of the body, including the skull. If you have ever
boiled a soup bone long enough, you have probably noticed this covering.

A cephalohematoma is a collection of blood under the dura mater. It is
almost always a complication of childbirth. It most commonly occurs when the
fetal head is forced through the birth canal; the head is propelled forward
while the cervix grips the scalp tenaciously. This sliding, tearing force
can tear tiny veins that nourish the dura mater from the bone side. This
tearing of vessles causes bleeding (hemorrhage) under the tough covering of
each bony plate (the "periosteum"), and a tense pocket of blood collects.
This is apparently a painless process.

The result is a squishy swelling with distinct borders that feels just as if
there were a tiny water-filled balloon under the scalp. It is differentiated
from caput succedaneum in that the caput is a more generalised and very
temporary swelling of the scalp and disappears in a day or two, but the
cephalohematoma becomes more distinct to see and feel over the first few
days of life.
Cephalohematomas are more common with forceps delivery, and can indicate the
presence of a skull fracture. An underlying skull fracture is especially
suspected if the cephalohematoma crosses suture lines in the skull.

The course of a newborn's uncomplicated cephalohematoma is benign. The
trapped blood cells break down and the component parts are reabsorbed into
the system for recycling or disposal. The heme becomes bilirubin, the iron
is recycled into new red blood cells. Calcium is deposited in the resolving
cephalohematoma, especially around the edge where the dura mater has been
lifted up. As the swelling begins to resolve, you will feel a distinct hard
ridge around the edge of the swelling, with a soft, balloon-like center.

Eventually, the entire remaining mass of the cephalohematoma becomes hard
and calcified, and then it too is reabsorbed and disappears. Within a few
months there will be no physical or xray detectable trace of the swelling.

Obviously, there is no treatment necessary or ever warranted for an
uncomplicated cephalohematoma. By no means should they ever be drained or
needled, because of the risk of introducing infection into the space.

The only problems I have ever seen related remotely to or confused with a
cephalohematoma were related to underlying skull fracture. Such problems are
extraordinarily rare. See leptomeningeal cyst.

--

Jamie
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  #4  
Old December 9th 06, 11:26 AM posted to misc.kids.pregnancy
Lara
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Posts: 26
Default Cephalohematoma, is this something to worry about?

Jamie Clark wrote:

http://www.drhull.com/EncyMaster/C/cephalohematoma.html

Cephalohematoma
There is a very tough tissue covering that encapsulates bones, called the
dura mater (DOO-rah MATE-er). It adheres tenaciously to the outer and inner
surfaces of all the bones of the body, including the skull. If you have ever
boiled a soup bone long enough, you have probably noticed this covering.

A cephalohematoma is a collection of blood under the dura mater.


Huh - I thought drhull was normally a fairly good site? Poking around
further, it looks like I'm muddling it up with another site.

The dura mater is the outer layer of the meninges; it lies around the
brain and spinal cord and inside the skull/vertebral column. The bone
lining he is referring to is called the periosteum. A cephalhaematoma,
being by definition on the outside of the skull, is most definitely not
to be confused with a subdural or epidural haematoma! The diagram here
makes the anatomy clear:

http://en.wikipedia.org/wiki/Cephalhematoma

Lara

  #5  
Old December 9th 06, 02:23 PM posted to misc.kids.pregnancy
[email protected]
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Posts: 46
Default Cephalohematoma, is this something to worry about?


concerned wrote:
I asked several nurses in the hospital and also our brand new
pediatrician about a soft squishy area on my newbord daughter's head.
They all assured me that it is a Cephalohematoma and nothing to worry
about. I asked again at the 5 day checkup at the pediatrican's office
and again 'it will go away'. She is 11 days old now and the puffy area
seems to have gotten larger.(or maybe I'm just obsessing over it making
it look larger to me??) I don't know if i'm worrying over nothing or if I
need to take her to the hospital to get checked out before next week's
pediatrician appointment in 5 days.

Anybody have any experience with these? The puffyest part is just off
to the right of the crown of the head(towards the top/back) and
circumference about the size of a silver dollar.


My ds had one of these. It took a good few weeks to disappear. He
developed jaundice day 2 but it was pretty much cleared by 2 weeks with
lots of bf'ing and sunlight. No problems with it whatsoever, was just
careful not to hold that part of his head because it was tender.
Somedays it looked larger than others.

HTH

Jeni

  #6  
Old December 10th 06, 06:58 AM posted to misc.kids.pregnancy
DontCallMe
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Posts: 1
Default Cephalohematoma, is this something to worry about?

concerned wrote in
7.131:

I asked several nurses in the hospital and also our brand new
pediatrician about a soft squishy area on my newbord daughter's head.
They all assured me that it is a Cephalohematoma and nothing to worry
about. I asked again at the 5 day checkup at the pediatrican's office
and again 'it will go away'. She is 11 days old now and the puffy
area seems to have gotten larger.(or maybe I'm just obsessing over it
making it look larger to me??) I don't know if i'm worrying over
nothing or if I need to take her to the hospital to get checked out
before next week's pediatrician appointment in 5 days.

Anybody have any experience with these? The puffyest part is just
off to the right of the crown of the head(towards the top/back) and
circumference about the size of a silver dollar.


Thanks to everyone for the replies, you've given me more info than I
could find on the web. Mostly I found VERY techical articles that
didn't describe in laymans terms how it would look/feel etc. Guess
i'll have to find something else to worry about, no shortage of those.

12th day, newbie parent
 




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