Infant cephalohematoma occurs in the event of an accumulation of blood in the space between the periosteum and skull of an infant, with blood vessels in the neonatal periosteum frequently rupturing, thus furthering complicating the cerebral hemorrhage in the infant.
Understanding Infant Cephalohematoma and Its Causes
In many cases, the origins of a given infant cephalohematoma are iatrogenic in nature, or in short, caused by medical professionals during the birth process. Generally, birth-assisting tools such as forceps or vacuums employed by medical professionals during routine or distressed deliveries are the external trauma rupturing the blood vessels. Ultimately, for practitioners, the question must be one of whether the trauma required to result in cephalohematoma was sufficient to also result in temporary or other permanent developmental complications for the newborn.
Risk factors associated with the increased likelihood of infants experiencing cephalohematoma, include:
- Above all, child cephalohematomas are the byproduct of a difficult or prolonged birth process, including risks being associated with prolonged labor, high risk, or multiple pregnancies
- Infants presenting as proportionally large to the birth canal of a mother stand increased risks of incurring a cranial cephalohematoma by way of the vaginal extraction process
- Infants in an unnatural or distressed birth position can present significant risks to obstetricians seeking to quickly, yet safely extract the fetus from high-risk labor
- Any vaginal or C-section birth involving the use of surgical tools, such as forceps or vacuums to remove the infant from the uterus or vaginal canal are frequent causes of mild to serious infant cephalohematomas.
Comparable to a similar birth injury of caput succedaneum, neonatal cephalohematoma comprises of visible deformation of an infant’s scalp area as caused by the pooling of fluid beneath dermal layers. However, in the case of cephalohematoma, the pooling of blood in this newborn infant scalp hemorrhage occurs between the periosteum and the dura of the skull, whereas caput succedaneum presents between layers further away from the infant’s brain above the periosteum, but still beneath the scalp. Finally, to external observation and confirmed by internal imaging, infant cephalohematoma swelling presents as a clearly defined pattern stemming from cranial bone formations found in subperiosteal spaces, whereas caput succedaneum presents as a rather amorphous, or organically defined pattern of blood and cerebrospinal fluid pooling above the infant’s skull.
Immediate and Long-Term Risks Associated with Infant Cephalohematoma
Unlike most brain or birth injuries, cephalohematoma alone does not pose any risk to the actual brain cells. Thus, infant cephalohematoma is also considered to be one of the milder possible brain or birth injuries that can occur during the birthing process, if the infant cephalohematoma stemming from blood vessel ruptures is not indicative of a larger, albeit much less visible traumatic injury to the infant’s brain.
However, bruising on any layer of an infant’s skull, especially those at subdermal levels like infant cephalohematoma, may be indicative of a blow or birth trauma that has caused additional injuries to the skull or brain of the patient. In cases of infants, especially infants experiencing a pre-term or complicated birth, cephalohematoma post-birth warrants further investigation by medical professionals to determine the possibility or extent of additional damages potentially arising during the childbirth process. In the bulk of cases, infant cephalohematoma resolves itself without any short or long-term implications for the child.
Long-Term Risks and Treatment Options for Infant Cephalohematoma
However, in certain percentages of cases in which the relatively superficial visible bruising is not linked to more traumatic brain injuries, strong linkages between later development of cerebral palsy and other developmental disorders exists. Symptoms associated with a cephalohematoma that are immediately indicative of a more serious brain injury during the birth process include jaundice, development delays, motor skill deficiencies, anemia, infection, and the non-resolution of the cephalohematoma in the infant over time. In these and other acute instances, the long-term and profound risks of brain injury causing cerebral palsy and other chronic development problems in infants necessitates immediate attempts to confirm or deny the existence of more serious birth injuries underlying the infant’s cephalohematoma by obstetricians or pediatricians.