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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.

 

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Volpe, 1995 Smith, 1992 differential diagnosis of extracranial hematomas