Answer:
Calcified Cephalhematoma
Findings:
Imaging depicts a crescentic subperiosteal haemorrhage overlying the right parietal bone with an external calcified elevated periosteal rim and internal rim (calvarium). The internal contents follows the signal of subacute hematoma.
Discussion:
Cephalhematoma represents subperiosteal hemorrhage. It is usually related to birth trauma or instrumentation during the delivery.The periosteum of the involved bone, usually parietal or occipital bone is elevated by the underlying hematoma. Therefore, the hematoma is strictly limited by the margins of the bone and does not cross suture lines.
In its earliest stages (first 2weeks), the hematoma is of soft tissue density due to its blood content. As healing progresses, there is formation of a shell of bone by the elevated periosteum and the calcification becomes visible on CT scan and plain radiograph of the skull. It initially appears as a thin calcified rim covering the hematoma. The layer of calcification subsequently thickens as it matures.
Following complete resorption of the hematoma, the calcified rim is incorporated into the outer table of the skull. This may persist for months or years as a palpable (and radiographically visible) thickening of the outer table of the skull. Subtle skull fractures underlying the cephalhematoma may coexist but are usually not clinically significant. The findings may persist for years, even into adulthood. A lytic-appearing lesion at the site of old cephalhematoma may also persist, and this entity should be kept in mind when evaluating lytic or cystlike skull lesions.
Reference:
Pediatric Brain and Spine, An Atlas of MRI and Spectroscopy by L.M.Ketonen A.Hiwatashi R.Sidhu P.-L.Westesson.
Contributed By:
Dr. Karunakaran M. Kalathi MD, Dr. Arun Chelladurai MD
Consultant Radiologists, Aarthi Scans, Thirunelveli, Tamilnadu, India
Calcified Cephalhematoma
Findings:
Imaging depicts a crescentic subperiosteal haemorrhage overlying the right parietal bone with an external calcified elevated periosteal rim and internal rim (calvarium). The internal contents follows the signal of subacute hematoma.
Discussion:
Cephalhematoma represents subperiosteal hemorrhage. It is usually related to birth trauma or instrumentation during the delivery.The periosteum of the involved bone, usually parietal or occipital bone is elevated by the underlying hematoma. Therefore, the hematoma is strictly limited by the margins of the bone and does not cross suture lines.
In its earliest stages (first 2weeks), the hematoma is of soft tissue density due to its blood content. As healing progresses, there is formation of a shell of bone by the elevated periosteum and the calcification becomes visible on CT scan and plain radiograph of the skull. It initially appears as a thin calcified rim covering the hematoma. The layer of calcification subsequently thickens as it matures.
Following complete resorption of the hematoma, the calcified rim is incorporated into the outer table of the skull. This may persist for months or years as a palpable (and radiographically visible) thickening of the outer table of the skull. Subtle skull fractures underlying the cephalhematoma may coexist but are usually not clinically significant. The findings may persist for years, even into adulthood. A lytic-appearing lesion at the site of old cephalhematoma may also persist, and this entity should be kept in mind when evaluating lytic or cystlike skull lesions.
Reference:
Pediatric Brain and Spine, An Atlas of MRI and Spectroscopy by L.M.Ketonen A.Hiwatashi R.Sidhu P.-L.Westesson.
Contributed By:
Dr. Karunakaran M. Kalathi MD, Dr. Arun Chelladurai MD
Consultant Radiologists, Aarthi Scans, Thirunelveli, Tamilnadu, India