Calcified cephalohematoma as an unusual cause of EEG anomalies: case report

Abstract

<jats:p>Cephalohematoma, one of the most common neonatal head injuries, generally undergoes spontaneous resorption. When calcified, it may cause cranial vault distortion and depression of the inner skull layer, although it remains asymptomatic. Surgery, indeed, is usually performed for cosmetic purposes. For these reasons, the long-term effects of calcified cephalohematoma (CC) are widely unknown.</jats:p> <jats:p>The authors report the case of an 11-year-old girl with a persistent calcified CC causing skull deformity and delayed electroencephalography (EEG) anomalies. These anomalies were detected during routine control EEG and were not clinically evident. The young girl underwent surgical removal of the CC for cosmetic purpose. The EEG abnormalities disappeared after surgery, thus reinforcing the hypothesis of a correlation with the brain “compression” resulting from the CC. To the best of the authors' knowledge this is the first time that CC-associated EEG anomalies have been described: even though these anomalies cannot be considered an indication for surgery, they merit late follow-up in case of skull deformity.</jats:p>

Canine calvarial subperiosteal hematomas are fluid to soft tissue attenuating mass‐like lesions with smoothly marginated peripheral mineralization on CT

“…In humans the incidence of ossification is 3–5% of all subperiosteal hematomas 13 . When ossified, subperiosteal hematomas are classified into two types based on the contour of the internal table in relation to the surrounding cranial vault 25,26 . In Type 1 calcified subperiosteal hematomas, the inner table is normal without encroachment into the cranial vault 23,25,26 .…”

“…When ossified, subperiosteal hematomas are classified into two types based on the contour of the internal table in relation to the surrounding cranial vault 25,26 . In Type 1 calcified subperiosteal hematomas, the inner table is normal without encroachment into the cranial vault 23,25,26 . Type 2 calcified subperiosteal hematomas cause depression of the internal table into the cranial vault 25,26 .…”

“…23,25,26 Type 2 calcified subperiosteal hematomas cause depression of the internal table into the cranial vault. 25,26 If large, they are more common to lead to deformities of the inner table of the skull (Type 2). 15,23,27 They can require surgical treatment for cosmetic reasons 3,21 when mineralized or if impinging on the cranial vault.…”

Is The Surgery Necessary at the Neonatal Cephalohematoma?

“…Yenidoğanlarda yaklaşım genellikle konservatiftir, çünkü kafatası geliştikçe sefal hematom yavaş yavaş emilir. Yapılan bazı yayınlarda, bir ay sonra emilmeyen sefal hematom için aspirasyon önerilmektedir (8) . Diğer yandan bazı yayınlarda ise aspirasyon neden olduğu enfeksiyon riski nedeniyle önerilmemektedir (11)(12)(13) .…”

“…Olguların yaklaşık %3-5'inde sefal hematom kalsifikasyona doğru ilerler (7,8) . Düzelmeyen kalsifiye dokunun tedavisi için ortak bir görüş bulunmamakta ve pek çok hekim estetik deformitenin düzeltilmesi, tanısal doğrulamanın yapılması, beyin büyümesinin kısıtlanmasının önlenmesi ve ilişkili kraniosinositozun düzeltilmesi için cerrahinin endike olacağını savunmaktadır (4,5) .…”