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Figure 4.7. Cephalhematoma over the right parietal bone. A cephalhematoma is a subperiosteal hemorrhage occurring as a result of vessel rupture at birth. It is generally not apparent at birth but is noted in the first day or two of life. It should be distinguished from a caput succedaneum. It is most commonly seen over the parietal bones and more commonly over the right parietal than the left. A caput succedaneum and cephalhematoma may occur concurrently.

Figure 4.8. Large left parietal cephalhematoma. Note that die cephalhematoma is limited by suture lines because it is a subperiosteal hemorrhage. Cephalhematoma occurs more commonly after prolonged primigravida labor or forceps delivery especially in post term infants where suture fusion makes the skull hard and unyielding.

Figure 4.9. Bilateral cephalhematomas in this infant demonstrate very clearly the limitation of the cephal-hematoma by suture lines. Complications of cephal-hematomas include anemia, jaundice, infection, and underlying skull fracture. In general, cephalhematomas resolve spontaneously over a period of weeks to months.

Figure 4.10. Cephalhematoma with linear fracture of the skull. This occurs in 4 to 5% of infants with a cephalhematoma.

Figure 4.11. Calcification in a cephalhematoma giving the lesion an "egg shell" feel occurs as a result of deposition of calcium in the organizing blood. Periosteal new bone forms around the perimeter of the cephalhematoma and this rim of calcification may be noted for several months.

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Figure 4.12. Infected cephalhematoma in an infant with Escherichia coli sepsis. Osteomyelitis of the underlying parietal bone was present.

Figure 4.12. Infected cephalhematoma in an infant with Escherichia coli sepsis. Osteomyelitis of the underlying parietal bone was present.

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