Related Experiment Videos
Bilateral cephalhematomas in a juvenile--case report
Kazunori Fujiwara1, Keiichi Saito, Tsutomu Ebina
1Deportment of Neurosurgery, Iwate Prefectural Iwai Hospital, Ichinoseki, Iwate, Japan. kfujiwara-nsu@umin.ac.jp
Insights
A pediatric case highlights subperiosteal cephalhematomas in a teen after head injury. Advanced imaging and surgical drainage proved effective for this rare condition.
Area of Science:
- Pediatric Radiology
- Neurosurgery
- Medical Imaging
Background:
- Subperiosteal cephalhematomas are rare, particularly in older children.
- Understanding their presentation and management is crucial for pediatric care.
Observation:
- A 14-year-old boy developed bilateral parietotemporal subperiosteal cephalhematomas post-head injury.
- Magnetic resonance (MR) imaging revealed hematoma extension beyond suture lines and under the temporal muscle layer.
- The hematomas enlarged progressively despite conservative and needle aspiration treatments.
Findings:
- Surgical exploration showed periosteal detachment from the skull bone and loss of attachment at suture lines.
- Continuous suction-drainage successfully reduced hematoma size without complications.
- MR imaging is effective in identifying subperiosteal cephalhematomas, with temporal muscle involvement being a key diagnostic indicator.
Implications:
- This case suggests juvenile cephalhematomas might represent a distinct clinical entity from neonatal cases.
- Effective management may involve surgical intervention, including continuous suction-drainage.
- MR imaging plays a vital role in diagnosing and characterizing these complex pediatric head injuries.
Abstract:
A 14-year-old boy presented with subperiosteal cephalhematomas in bilateral parietotemporal sites after a minor head injury. Magnetic resonance (MR) imaging showed that one of the hematomas had progressed beyond suture lines, and spread under the temporal muscle layer. Progressive enlargement of the cephalhematomas occurred despite medical and needle aspiration treatment. Surgery found that the hematoma had separated the periosteum from the skull bone surface, and the periosteum had lost the tight attachment to the suture lines. Continuous suction-drainage reduced the size of the hematomas without complications. MR imaging can identify subperiosteal cephalhematomas. The relationship of the hematoma and the temporal muscle may be the key MR imaging finding for the diagnosis of cephalhematoma. We suggest that some juvenile cephalhematomas may be a different clinical entity from those occurring in neonates.