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Published on: May 26, 2023
[Surgical treatment of ossified cephalhematoma: a case report]
Kohei Chida1, Naohiko Kubo, Takeshi Suzuki
1Department of Neurosurgery, Morioka Red Cross Hospital, 6-1-1 Sanbonyanagi, Morioka-shi, Iwate 020-8560, Japan.
Insights
This case report details an ossified cephalhematoma causing skull deformity in an infant. Surgical intervention with cranioplasty successfully corrected the deformity and relieved brain compression.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Medical Imaging
Background:
- Cephalhematoma is a common birth injury, typically resolving spontaneously.
- Ossified cephalhematoma, a rare complication, can lead to skull deformities and require surgical intervention.
Observation:
- A neonate presented with a large left parietal cephalhematoma that calcified after 3 months.
- Radiographic and CT imaging revealed a bony protrusion with an invaginated inner table, indicating ossification and potential brain compression.
Findings:
- 3D-CT demonstrated significant bony protrusion of the left parietal bone.
- MRI confirmed an old hematoma within the protruding bone and compression of the underlying parietal lobe.
Implications:
- Cranioplasty using resected bone and bioabsorbable plates is an effective treatment for ossified cephalhematoma causing skull deformity.
- Bioabsorbable materials are advantageous in pediatric cranioplasty, allowing for skull growth without interference.
Abstract:
We report a surgical case of ossified cephalhematoma which caused deformity of the skull. A boy was delivered with the aid of vacuum extractor at 40 gestational weeks. He presented with a big cephalhematoma in the left parietal region, and it remained and calcificated after 3 months. He was admitted after being diagnosed with ossified cephalhematoma. Plain skull radiograph showed a marginated radiolucent lesion with a protrusive outer table and a slightly invaginated inner table in the left parietal region. Plain CT scan showed a low density lesion between bony layers and the depressed inner table with irregular thickening. 3D-CT shows bony protrusion of the left parietal bone with thinning in the center. Magnetic resonance imaging revealed an old hematoma in the protruding bone and compression of the parietal lobe by the inner table. For cosmetic reasons and relief of compression of the brain, cranioplasty was performed at 7 months. The protruding bone was removed totally and was arranged to fit in the convex after being cut in pieces. Using bioabsorbable mini plates and screws, the bone was fixed firmly. For cranioplasty of a child, absorbable plates and screws are useful because of their non-interference with growth of the skull.