Abstract

Ossified Cephalhematoma is a rare complication of head trauma in neonates. Incidence of cephalhematoma ranges from 0.4% to 3%. Subperiosteal hematoma (also known as cephalhematoma) is the most common type of birth trauma. It became calcified in less than 5% of children. The most common site of involvement was the parietal bone. Brain CT aids in the diagnosis of a cephalhematoma as well as its complications. Treatment entails conservative and or surgical. Surgery may be indicated for correction of cosmetic deformity, diagnostic confirmation, prevention of brain growth restriction, and correction of associated craniosynostosis.
Case summary
We present a case of a 2-month-old male infant delivered by a primipara via spontaneous vaginal delivery, presenting with a history of scalp swelling over the left parietal region noticed since birth, initially soft, which later became hard over 4 weeks. There was no neurological deficit. No history of assisted delivery, however, there was a history of prolonged labour for about 18 hours. Examination revealed a swelling on the left parietal region, measuring 10cm x 8cm, firm, attached to the skull, with a normal scalp that was freely mobile over it. His Apgar scores were 8 and 10 at 1st and 5th minutes, his birth weight was 3kg. Computed tomographic scan of the brain showed a normal brain and double skull sign on the left parietal bone. His blood investigations were normal. Diagnosis of Ossified Left Parietal Cephalhematoma was made. Surgery was performed due to parental concern about cosmetic deformity. He had a craniectomy of the ossified bone. The post-operative period was uneventful. He was followed up postoperatively after three months and then every two months for twelve months. He did well, and there was no recurrence.
Conclusions: The patient had an excellent cosmetic outcome and no recurrence during the follow-up period, which further strengthened the role of surgery in the treatment of ossified cephalhemato

Key words: Birth injury, ossification, cephalhematoma, lamella, craniectomy