CEPHALHEMATOMA (Greek kephale the head + haima, haimat [os] blood + - oma; synonym cephalhaematoma externum, «a blood tumor») — hemorrhage under a periosteum of any bone of a skull at newborns. Most often To. it is noted in a parietal bone on the one hand, much more rare happens bilateral. At buttock presentation To. can arise in an occipital bone.
In an etiology To. the shift of skin in relation to bones of a skull sometimes arising at childbirth matters. Obstetric grants — an application of forceps and especially use of a vacuum extractor increase probability of emergence To. Influence of the raised bleeding owing to deficit of phthiocol and fragility of a wall of vessels is not excluded. Frequency To. makes 1 — 2% at all childbirth.
To. represents limited tumorous formation of a myagkoelastichesky consistence, a cut usually comes to light on 2 — the 3rd days after the birth in process of fall of the patrimonial tumor caused by hypostasis of soft tissues and hemorrhage in hypodermic cellulose. In the next few days To. can increase, reaching the sizes of small apple (to 150 — 200 ml of blood). Characteristic signs To., except fluctuation, existence of the dense crateriform roller on its edges at the expense of the condensed periosteum is, and also the fact that it never passes for borders of seams to other bones.
Existence To. at its usual current considerably does not affect the general state: the hematoma is exposed to a spontaneous rassasyvaniye during 6 — 8 weeks. At this time it is defined at a palpation as the uneven consolidation decreasing in sizes. In some cases there is suppuration of a hematoma, is more often — at grazes or scratches in this area. Suppuration is shown as local symptoms of an inflammation (a hyperemia, infiltration), and the general reaction of an organism (temperature increase, deterioration in appetite, concern or slackness).
Sometimes To. is exposed to calcification and ossification. In these cases the deformations of the corresponding bone which radiological are shown its thickening on site being To are formed.
Differential diagnosis is carried out with a patrimonial tumor (hemorrhage to hypodermic cellulose), edges has a pasty consistence, extends for borders of seams to other bones and does not flyuktuirut, disappearing usually in the first 2 — 3 days (see. Caput succedaneum ). Brain hernias are located on border of bones in the field of seams, increase at a tension and crying, quite often pulse unlike To. If there is a fracture of a bone of a skull, To. extends for borders of seams. At strained To. the X-ray analysis of a skull for an exception of the accompanying changes is reasonable.
At an uncomplicated current To. special treatment is not required. Only at very big sizes K. its emptying by a puncture with the subsequent introduction of antibiotics and imposing of the pressing sterile bandage is reasonable. This procedure is performed at the beginning of the 2nd week in order to avoid the recurrence caused raised fiziol bleeding at children of the first days of life. In later terms evacuation To. it can be complicated owing to the organization of its contents.
At suppuration of a hematoma she is treated as abscess (see).
Bibliography: Doletsky S. Ya., and in-ryushov V. V. and Akopyan V. G. Hirurgiya of newborns, M., 1976.
V. I. Geraskin.