Cephalohematomas
are subperiosteal hemorrhages. Blood accumulates between the periosteum
and the external surface of the bone.
The mass feels hard and, unlike caput succedaneum and subgaleal hemorrhages,
it does not cross the sutures. A raised hard rim is often felt at the
edges of the mass. Cephalohematomas may be associated with skull fractures.
Cephalohematomas require no treatment. Linear and depressed skull fractures
usually involve the parietal bones.Linear
skull fractures can not be diagnosed clinically. A skull radiograph
is necessary. Depressed skull fractures manifest clinically as a depression
in the contour of the skull. Linear bone fractures in the neonatal period
require no treatment unless they are complicated by an internal injury.
Treatment of depressed fractures consists of elevation of the depressed
bone by using a breast pump attached to an obstetrical vacuum or by
a neurosurgical procedure if the breast pump procedure fails. Retinal
bleeding occurs in a large number of normal births and, unless extensive,
should not be considered a suggestive sign of brain injury.