ACR Codes: 1.4
Cephalohematoma -- A subperiosteal hemorrhage, similar to an epidural hematoma, but on the opposite side of the calvarium. Similarly, this hemorrhage is contained by the sutures. CEphalohematomas occur in up to 1% of deliveries, but the incidence greatly increase with the use of forceps during delivery. These hemorrhages may calcify/ossify, which may lead to the so-called, \"Double Skull Sign.\"
This is compared to the other two common forms of birth trauma:
Caput Succedaneum - Edema and hemorrhage within the skin, frequently occurring after vaginal deliveries. The edema is superficial, compressible, and will resolve within the first few days of life. This edema will cross the sutures, as it is within the superficial soft tissues.
Subgaleal Hemorrhage -- This hemorrhage resides adjacent to the calvarial aponeurosis below the occipito-frontalis muscles. This lesion is firm and fluctuant, and may increase in size in the first few days of life. Eventually, it will resolve over a few weeks. Rarely will the newborn become symptomatic from the blood loss.
Reference(s): 1. A. James Barkovich. Pediatric Neuroimaging, 4th Ed. 2005.
2. Uemura A, O'uchi T, Kikuchi Y. Double SKull Sign of Ossified Cephalohematoma on CT. European Journal of Radiology Extra 2004;49: 35-36.