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By: Ismah Haron

Caput succedaneumCephalhaematoma

Subarachnoid hemorrhage

2http://vetsci.co.uk/2010/02/10/meninges-csf-venous-drainage/

3http://www.netterimages.com/image/57529.htm

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4http://emedicine.medscape.com/article/980112-overview#aw2aab6b4

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CAPUT SUCCEDANEUM• Bruising and oedema of presenting part extending beyond the margin of the skull bone [1]

• Prolonged delivery, ventouse delivery [2]

• Pressure from uterus and vaginal wall during vaginal delivery [3]

• Detected on ultrasound/vaginal examination [3]

• Resolves in few days [1][2][3]

• Usually no complication [2][3]

http://www.netterimages.com/image/57529.htm

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http://www.humpath.com/?caput-succedaneum&id_document=16658

Caput succedaneum

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CEPHALHAEMATOMA• Bleeding below periosteum, confined within margins of the skull suture [1]

• More common while using metal cup [2]

• Resolved in 4 to 6 weeks [2]

http://www.netterimages.com/image/57529.htm

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• Complications include

a. Anemia, jaundice (1-16%) [2]

b. Calcified (hard around the edge, soft at the center): will resolved [4]

c. Hypotension, focus of infection; meningitis, osteomyelitis [4]

• Occasionally associated by linear skull fracture (5-20%) [4]

Linear right parietal skull fracturehttp://www.medandlife.ro/medandlife602.html

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• Bleeding beneath periosteum

• Within margin of skull suture

• Precipitating cause is similar in caput, but may be in more severe condition

• Resolved in 4-6 weeks

• Usually no complication, but have serious complication as mention previously

• Bruising and edema beneath scalp

• Beyond margin of skull bone

• Prolonged delivery, ventouse delivery

• Resolved in few days

• Usually no complication

Caput succedaneum Cephalhematoma

11http://www.netterimages.com/image/57529.htm

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12http://emedicine.medscape.com/article/980112-overview#aw2aab6b4

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http://mediphotos.blogspot.com/2012/01/illustrated-cephalohematoma-vs-caput.html

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Cephalhaematoma Cephalhaematoma

Caput succedaneumhttp://newborns.stanford.edu/PhotoGallery/Caput3.html

T. Lissauer, G. Clayden. Illustrated Textbook of Pediatrics 3rd edition.

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SUBARACHNOID HEMORRHAGE • Prolonged labour, forceps or ventouse delivery [5]

• Pressures exerted on the neonate’s head during labour ± hematologic disorders [5]

• Features [5] :

Apnoea, seizures, lethargy

Vital signs, bulging fontanelle, HC increase rapidly, lack symmetric movement

• Cranial ultrasound, CT scan, FBC, clotting studies etc. [5][6]

http://www.merckmanuals.com/home/brain_spinal_cord_and_nerve_disorders/stroke_cva/hemorrhagic_stroke.html

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• The prognosis is usually good [5][6]

• Large haemorrhages may associated with meningeal inflammation --> communicating hydrocephalus as the infant grows [5]

• Supportive management:

Provide adequate ventilation, keep the newborn's vital organs well perfused [6]

• Most of the time, not required surgery [6]

http://neuropathology-web.org/chapter3/chapter3dGmh.html

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THANK YOU

References:

1. T. Lissauer, G. Clayden. Illustrated Textbook of Pediatrics 3 rd edition.

2. R. K. Creasy. Management of Labor and Delivery.

3. Caput Succedaneum. A.D.A.M. Medical Encyclopaedia. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002554/

4. Nirupama Laroia, MBBS, MD. Pediatric Cardiac Birth Trauma. http://emedicine.medscape.com/article/980112-overview#aw2aab6b4

5. Gupta, S. N., Kechli, A. M., & Kanamalla, U. S. (2009). Intracranial hemorrhage in term newborns: management and outcomes. Pediatric neurology, 40(1), 1-12.

6. Birth Injuries. http://www.merckmanuals.com/professional/pediatrics/perinatal_problems/birth_injuries.html