What is a cephalohematoma?

A cephalohematoma is a clot that occurs in the area between the skull and the periosteum (the membrane that covers the skull) as a result of ruptured blood vessels. Cephalo- means “head” or “skull,” and a hematoma is a type of internal bleeding (usually clotted) that occurs outside of a blood vessel.

Infant cephalohematomas can emerge as the result of a difficult or prolonged birth, and often co-occur with other types of birth trauma such as a caput succedaneum. Cephalohematomas are also associated with the use of birth-assisting tools such as forceps or vacuum extractors. Infant cephalohematomas usually heal without any major medical intervention, but if improperly treated, the consequences can be more serious.

Cephalohematoma neonatal head injury

How do doctors diagnose a cephalohematoma?

Usually, a cephalohematoma will manifest as a raised bump on a baby’s head. The bump typically appears several hours to a day after birth and is often largest on the second or third day.  The cephalohematoma may initially be soft, but get firmer over time.

Often, appearance alone is enough to diagnose a cephalohematoma. To verify, however, doctors may order an X-rayCT scanMRI scan, or ultrasound.

What can cause a cephalohematoma?

Any type of trauma to the baby’s head can potentially cause a cephalohematoma. More specific examples include the following:

  • Prolonged or difficult delivery. This may be caused by a variety of factors, including cephalopelvic disproportion (the baby’s head is larger than the mother’s pelvic opening) and fetal macrosomia (the baby is larger than is expected for gestational age).
  • Abnormal fetal position
  • Birth of multiples (twins, triplets, or more)
  • Use of forceps or vacuum extractors: These assistive delivery tools can increase the risk of not only cephalohematomas, but many other problems, including permanent brain damage. Therefore, they must be used only by very experienced medical professionals, and only under a strict set of circumstances.
vacuum delivery
Misuse of forceps and vacuums may cause a cephalohematoma

How are infant cephalohematomas treated?

In most instances, cephalohematomas go away on their own without any major medical intervention, although babies with cephalohematomas should be carefully monitored. Occasionally doctors attempt to drain/aspirate the blood, but this is generally not advised because it increases the risk of infection and abscess. However, if a cephalohematoma becomes infected or abscessed, drainage may then be indicated (along with antibiotic treatment). Doctors must manage infections of cephalohematomas very carefully, because this can lead to meningitis (infection of the brain).

Although cephalohematomas are generally not a major threat, they can increase the risk of health complications such as anemia and jaundice.

If a baby develops anemia, they may require a blood transfusion. Like cephalohematomas, jaundice may only be a mild issue, and it is easily treatable . However, babies with jaundice should be closely monitored. If jaundice becomes severe and doctors fail to provide appropriate treatment, it can result in cerebral palsy (CP), hearing loss, and other permanent disabilities.


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4. Neonatal Jaundice Treatment & Management: Approach Considerations, Medical Care, Diet. (2018, July 25). Retrieved September 13, 2023, from https://emedicine.medscape.com/article/974786-treatment#d6

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