Calcified Cephalohematoma: an unusual case

Abstract

Introduction: A cephalohematoma is characterized by a collection of serosanguineous fluid localized in the sub periosteum space, being the most common birth injury to the head. It occurs in up to 2.5% of all live births. Rarely a cephalohematoma persists and may calcify. We present a case that illustrates a calcified cephalohematoma that was reabsorbed. Case report: A two-month-old infant presented to the Pediatric Consultation at a first level hospital with a history of persistent right parietal mass, with no other symptoms He was born from instrument-assisted delivery with vacuum and about 72 hours after birth a right parietal tumefaction associated with cutaneous erythema was observed. At the physical examination on the first Pediatric Consultation, he presented with a 3-centimeter-long right parietal mass with hard consistency and no other alterations. Cranial X-rays were requested and showed images compatible with a calcified cephalohematoma, without apparent internal lamina alterations. A wait and see approach was conducted. At twelve-month-old, the mass had been completely reabsorbed and the child’s neurodevelopment was globally adequate. Currently, with four-years-old, the neurodevelopment remains adequate. Discussion and conclusion: Even though cephalohematoma is the most common birth injury to the head, in most cases it is reabsorbed in two to four weeks. Rarely a cephalohematoma persists and may calcify. An adequate medical history and physical examination are very important for a correct diagnosis. Cranium radiography is usually the first line imaging strategy and this patient radiographies were particularly evocative of the diagnosis. In this case a wait and see approach was conducted, the calcified cephalohematoma spontaneously reabsorbed, and the patient showed a good outcome.