Difference Between Subgaleal Hematoma and Cephalohematoma

A subgaleal hematoma is a condition where blood collects between the galea aponeurosis tissue and the periosteum of the skull. A cephalohematoma is a condition where blood is found underneath the skull because of periosteum blood vessels rupturing.

What is Subgaleal hematoma?

Definition:

A subgaleal hematoma is when blood collects between the periosteum and the galea aponeurosis. The aponeurosis is dense fibrous connective tissue just beneath the skin of the skull, while the periosteum is a membrane that surrounds bone (in this case, the skull bone).

Symptoms: 

The symptoms of a subgaleal hematoma include a bulge on the head along with bruising and discoloration in that area. The baby may also have pale skin, hypotension, swelling of the scalp, and a sped-up heart rate. 

Causes:

The cause of a subgaleal hematoma is usually trauma and injury during birth. Sometimes the use of forceps or a vacuum extractor can cause this condition in a newborn. A blood clotting disorder in the newborn is another potential reason for bleeding and the development of a subgaleal hematoma.

Diagnosis:

Diagnosis of the condition can be based on physical symptoms and also imaging tests such as CT, ultrasound, and MRI tests.

Treatment:

Treatment is mainly supportive and includes a blood transfusion and giving saline. The hematocrit of the newborn will be checked to ensure the transfusion is helping. In severe cases, surgery may be needed.

Complications/increased risk:

There are possible complications in severe cases of subgaleal hematoma. The newborn may develop seizures, neonatal encephalopathy, and death.

What is Cephalohematoma?

Definition:

This is when blood collects under the scalp of a newborn because of periosteum blood vessels breaking.

Symptoms:

The sign of a cephalohematoma is a bulging area on the back of the baby’s head. The skin starts off soft over the bulging area and then hardens. There is no change in color or bruise on the area.

Causes:

The cause of a cephalohematoma is a difficult birth in which a vacuum extractor or forceps are used on the infant. It can also happen if a newborn is very large, and labor is very long. The small blood vessels on the surface of the skull rupture due to high pressure.

Diagnosis:

The condition can be diagnosed by observing the bulge on the head but some doctors do also suggest using CT scans or ultrasound to confirm it is a cephalohematoma and not any other worse issue.

Treatment:

Usually, no treatment is needed and the infant is simply watched to make sure that the issue resolves over time. Sometimes the newborn can go home with the parents who can watch for any change, particularly behavioral changes that may indicate the baby is in pain.

Complications/increased risk:

Babies born with a cephalohematoma are at higher risk of jaundice, infections, and also anemia. 

Difference between Subgaleal hematoma and Cephalohematoma? 

Definition

A subgaleal hematoma is when there is blood accumulating between the periosteum and tissue known as galea aponeurosis. A cephalohematoma is when there is blood pooling under the scalp of the baby because of blood vessels in the periosteum breaking.

May extend into the neck region

In the case of a subgaleal hematoma, it can move down into the neck area while this does not happen with a cephalohematoma.

Symptoms

In the case of a subgaleal hematoma, there is a bulge on the head and the skin changes color and looks bruised. This is not the case for a cephalohematoma, where there is only a bulge and no color change or bruise.

Complications/increased risk

The complications of a subgaleal hematoma include the following: neonatal encephalopathy. A cephalohematoma increases the risk of an infant developing anemia, and jaundice.

Treatment

A subgaleal hematoma sometimes needs surgery but other times, an infant is watched to see if the condition is resolved. A cephalohematoma does not usually need any treatment but infants should be observed for any changes.

Table comparing Subgaleal hematoma and Cephalohematoma

Summary of Vs. Subgaleal hematoma and Cephalohematoma

• A subgaleal hematoma and cephalohematoma both affect newborns when there is a difficult delivery.
• A subgaleal hematoma is more serious than a cephalohematoma.
• Infants with a cephalohematoma can sometimes be sent home but parents need to carefully watch for any signs of behavior changes.

FAQ

How can you tell the difference between a caput succedaneum and a subgaleal hemorrhage?

A caput succedaneum just means that a newborn has a swollen head because of delivery. It is not harmful and goes away on its own. A subgaleal hemorrhage, though, is more serious because there is actual bleeding happening under the scalp between connective tissue and the skull.

What is subgaleal hematoma?

This is when there is an accumulation of blood in the head of a newborn specifically occurring between the periosteum and dense fibrous connective tissue.

What is a cephalohematoma?

A cephalohematoma is pooled blood under the scalp of an infant due to the rupture of small blood vessels found in the periosteum.

How do you know if you have a subgaleal hematoma?

Imaging methods such as CT scans, ultrasound, and MRI can diagnose a subgaleal hematoma.

What is the difference between cephalohematoma and caput?

A caput is a term used to describe a swelling due to pressure on the head during a head-first delivery of a baby. A cephalohematoma is when there is some actual bleeding under the scalp due to a difficult delivery.

What is subgaleal hemorrhage in newborn?

A subgaleal hemorrhage in a newborn is when there is an active bleed that happens between the galea and the periosteum of the skull.

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