Cephalohematoma
Cephalohematoma
presents as a localized mass that does not cross suture lines. It is usually
unilateral and over the parietal bone. The blood collects between the
external periosteum and the bone. The mass is firm, tense, and confined
to an individual bone. The edge of the mass may feel like a ridge. Underlying
linear fracture is detected in 10% to 25% of cases. Cephalohematoma is
produced by forces that tend to separate the periosteum from the bone.
Complications are hyperbilirubinemia, late onset anemia, and osteomyelitis.
Cephalohematomas require no treatment. Complications should be treated
accordingly.
SKULL
Increased
thickness of the skull can occur with osteopetrosis. Osteopetrosis is
a disorder characterized by overgrowth of brittle bones. This results
in thick, dense, and fragile bones. The bony tissue overgrowth results
in encroachments of the: (1) bone marrow leading to anemia, (2) cranial
nerves foramina leading to deafness, blindness, or other signs of cranial
nerve dysfunction, (3) Pacchioni bodies producing communicating hydrocephalus
and macrocephaly. Osteopetrosis may be an autosomal recessive or an autosomal
dominant disorder but only the autosomal recessive form occurs during
the neonatal period.
Neonates with osteopetrosis
may present with hypocalcemic seizures. Hepatomegaly is not usually present
in the neonatal period. Alkaline phosphatase is increased. This condition
is diagnosed by obtaining whole-body radiographs. Radiographs show dense
bones, anterior notching up the vertebral bodies, thick ribs, and a bone-within-bone
appearance of the hands.
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