Almousa, A

Dabbous, B

Shtaya, A

Anan Shtaya

Ala'a Almousa

Bassam Dabbous

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Pediatrics & Neonatology

A rare case of a calcified cephalhematoma mistaken as a skull fracture

St George's Online Research Archive

+ MODELPediatrics and Neonatology (2017) xx, 1e2Available online at www.sciencedirect.comScienceDirectjournal homepage: http: / /www.pediatr -neonatol .comImagesA rare case of a calcified cephalhematomamistaken as a skull fractureAnan Shtaya a,b,*, Ala’a Almousa a, Bassam Dabbous aa Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute,St George’s University of London, London, UKb Atkinson Morley Neurosurgery Centre, St George’s University Hospital NHS Trust, London, UKReceived Jul 7, 2017; received in revised form Aug 16, 2017; accepted Nov 10, 2017Available online - - -A 2-month-old-boy presented to our emergency departmentwith an apparent depressed area in the left parietal region.His mother informed the emergency department aboutventouse and forceps-assisted delivery at 41 weeks’gestation with unremarkable antenatal care. She noticedan initial soft swelling that was diagnosed at the time as acephalhematoma and was conservatively treated. Theswelling eventually decreased in size and hardened. Therewas no history of trauma; clinical examination was unre-markable apart from positional plagiocephaly and thepresence of a depressed area in the left parietal region.Skull X-ray was inconclusive; ultrasound (Fig. 1A) suspecteda skull fracture. Head computed tomography (Fig. 1CeF)revealed an outer surface of calcified cephalhematomathat collapsed inward, giving the appearance of adepressed parietal fracture. The natural course of cepha-lhematomas is gradual resorption1; however, they may* Corresponding author. Neurosciences Research Centre, Molecular aLondon, London SW17 0RE, UK.E-mail address: ashtaya@sgul.ac.uk (A. Shtaya).Please cite this article in press as: Shtaya A, et al., A rare case of a calcNeonatology (2017), https://doi.org/10.1016/j.pedneo.2017.11.004https://doi.org/10.1016/j.pedneo.2017.11.0041875-9572/Copyright ª 2017, Taiwan Pediatric Association. PublishedCC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/rarely require surgery.2 Although extremely rare, cepha-lhematomas may ossify.3 Calcified cephalhematoma hasbeen described as an overlying parietal defect; however,we report an unusual appearance that was mistaken for afracture. Depressed calcified cephalhematoma is extremelyrare and can be conservatively managed when no con-cerning deformity is present, as in this case.DisclosureThe authors have nothing to disclose or declare in relationto this submission.FundingThis case was completed with no dedicated funding.nd Clinical Sciences Research Institute, St George’s University ofified cephalhematoma mistaken as a skull fracture, Pediatrics andby Elsevier Taiwan LLC. This is an open access article under the4.0/).Figure 1 A. An ultrasound scan of the skull lesion, which demonstrates the suspected depressed left. parietal fracture (arrow).The right side of figure A shows normal skull ultrasound. B. Skull X-ray showing the suspected abnormal area (arrow). C. An axialbone-window head computed tomography (CT) showing the calcified cephalhematoma (arrow). D. A sagittal bone-window head CTshowing the fractured calcified cephalhematoma (arrow) and bony defect (solid arrow). E. A coronal bone-window CT showing thedepressed calcification (arrow). F. Three-dimensional reconstruction of head CT showing the calcified swelling (arrow).2 A. Shtaya et al+ MODELReferences1. Yoon SD, Cho BM, Oh SM, Park SH. Spontaneous resorption ofcalcified cephalhematoma in a 9-month-old child: case report.Childs Nerv Syst 2013;29:517e9.2. Jang DG, Kang SG, Lee SB, Yoo DS, Huh PW, Cho KS, et al. Simpleexcision and periosteal reattachment for the treatment ofPlease cite this article in press as: Shtaya A, et al., A rare case of a calcNeonatology (2017), https://doi.org/10.1016/j.pedneo.2017.11.004calcified cephalhematoma. Technical note. J Neurosurg 2007;106:162e4.3. Kaiser GL, Oesch V. Sagittal craniosynostosis combined withossified cephalhematomaea tricky and demanding puzzle.Childs Nerv Syst 2009;25:103e10.ified cephalhematoma mistaken as a skull fracture, Pediatrics and

A rare case of a calcified cephalhematoma mistaken as a skull fracture.

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A rare case of a calcified cephalhematoma mistaken as a skull fracture.

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