Cephalohematoma: A Complete Guide

Written by Medicover Team and Medically Reviewed by Dr Neha Mukhi , Pediatricians

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Cephalohematoma is a birth-related condition in newborns in which blood collects between the skull bone and its outer covering (periosteum). It usually develops due to pressure on the baby's head during a difficult delivery, prolonged labor, or the use of forceps or a vacuum extractor. The swelling typically appears within a few hours after birth and is confined to a single skull bone.

Although Cephalohematoma often resolves without treatment within a few weeks or months, careful monitoring is important to detect complications such as jaundice, anemia, or infection. Regular follow-up with a healthcare provider helps ensure proper healing and healthy development.

What are the Types of Cephalohematoma?

Cephalohematoma can be classified based on the location and extent of blood accumulation beneath the scalp.

Linear Cephalohematoma: Blood collection confined to a single skull bone.
Subperiosteal Cephalohematoma: Bleeding occurs between the periosteum and the skull bone.
Subgaleal Hemorrhage: Blood collects between the galea aponeurotica and the periosteum, spreading over a larger area.
Bilateral Cephalohematoma: Blood accumulation occurs on both sides of the baby's head.
Unilateral Cephalohematoma: Swelling is limited to one side of the head.
Large Cephalohematoma: A significant collection of blood that may require closer monitoring for complications.

What are the Symptoms of Cephalohematoma?

Symptoms usually become noticeable within hours after birth and gradually improve as the blood is naturally absorbed.

Scalp Swelling: A soft or firm swelling over one area of the skull.
Localized Lump: A well-defined swelling that does not cross skull suture lines.
Tenderness: Mild tenderness when the affected area is touched.
Jaundice: Yellowing of the skin or eyes caused by the breakdown of accumulated blood.
Anemia: Large cephalohematomas may contribute to low red blood cell levels.
Rare Infection: Redness, warmth, or fever may indicate an infected cephalohematoma.

What are the Causes of Cephalohematoma?

Cephalohematoma usually develops due to pressure or trauma affecting the baby's head during childbirth.

Prolonged Labor: Extended labor increases pressure on the baby's skull.
Forceps Delivery: The use of forceps may cause injury to blood vessels beneath the scalp.
Vacuum-Assisted Delivery: Vacuum extraction can increase the risk of bleeding beneath the periosteum.
Difficult Delivery: Complicated births may place excessive pressure on the infant's head.
Premature Birth: Premature infants have more delicate skull structures that are prone to injury.

When Should You See a Pediatrician for Cephalohematoma?

Although many cases of Cephalohematoma resolve on their own, you should consult a Pediatrician if your newborn develops persistent scalp swelling, signs of infection, jaundice, or feeding difficulties. Early medical evaluation helps monitor healing, detect complications, and ensure your baby's healthy development.

Increasing Scalp Swelling: The swelling becomes larger, firmer, or does not improve over time.
Yellowing of the Skin or Eyes: Signs of jaundice that may develop due to the breakdown of accumulated blood.
Redness or Warmth Over the Swelling: These may indicate an infection requiring prompt medical treatment.
Poor Feeding or Excessive Sleepiness: Difficulty feeding, lethargy, or unusual irritability should be evaluated immediately.
Fever: Any fever in a newborn requires urgent medical assessment.
Breathing or Neurological Changes: Seizures, abnormal movements, poor muscle tone, or difficulty waking the baby need emergency care.
Persistent Swelling: A scalp swelling that remains for several weeks or appears to harden should be assessed by a specialist.

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How is Cephalohematoma Diagnosed?

Diagnosis is primarily based on a physical examination and, if necessary, imaging tests to assess the extent of bleeding and exclude skull fractures.

Physical Examination: Evaluation of the size, location, and characteristics of the scalp swelling.
Birth History: Review of labor, delivery method, and any birth-related complications.
Ultrasound: May be used to evaluate the swelling and underlying tissues.
X-ray, CT Scan, or MRI: Recommended when skull fractures or deeper injuries are suspected.

What are the Treatment Options for Cephalohematoma?

Most cases require observation only, as the accumulated blood is gradually absorbed by the body without intervention.

Observation: Regular monitoring until the swelling resolves naturally.
Jaundice Management: Phototherapy may be required if significant jaundice develops.
Treatment of Anemia: Severe blood loss may occasionally require blood transfusion.
Antibiotics: Prescribed if infection develops.
Supportive Care: Regular pediatric follow-up to monitor healing and identify complications.

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What are the Risk Factors of Cephalohematoma?

Several maternal and delivery-related factors increase the likelihood of Cephalohematoma in newborns.

Prolonged Labor: Extended labor increases pressure on the infant's head.
Forceps or Vacuum Delivery: Instrument-assisted deliveries significantly increase the risk.
First Pregnancy: First-time mothers may have longer labor, increasing delivery-related pressure.
Large Baby (Macrosomia): Larger babies are more likely to experience birth trauma.
Premature Birth: Premature infants have more fragile skull bones and tissues.
Multiple Pregnancy: Twin or multiple births may involve more complex deliveries.