Summary about Disease
A subperiosteal hematoma is a collection of blood between the periosteum (the membrane covering the bone) and the bone itself. It most commonly occurs in children, particularly infants, and often results from birth trauma or accidental injury. It can occur in any bone but is more frequently seen on the skull, specifically the parietal bone. While generally benign, it can cause visible swelling and, in rare cases, may require medical intervention.
Symptoms
A visible, palpable swelling on the bone, typically on the skull.
The swelling is usually firm to the touch but may feel fluctuant (like it contains fluid).
The swelling doesn't cross suture lines (the junctions between the skull bones).
Possible discoloration (bruising) of the overlying skin.
In infants, there may be associated irritability or feeding difficulties.
Rarely, large hematomas can cause increased intracranial pressure.
Causes
Birth trauma: Pressure on the fetal skull during delivery, especially during prolonged or difficult labor, or with the use of vacuum extraction or forceps.
Accidental injury: Falls or blows to the head, particularly in young children.
Underlying bone disease (rare): Conditions that weaken the bone structure.
Bleeding disorders (rare): Conditions that impair the body's ability to clot blood.
Medicine Used
4. Medicine used Generally, specific medications are not used to treat subperiosteal hematomas. The primary approach is observation. However, in rare cases where complications arise (e.g., infection), antibiotics may be necessary. Pain relievers (e.g., acetaminophen or ibuprofen) may be used to manage any discomfort. Vitamin K may be administered in newborns if vitamin K deficiency is suspected as a contributing factor.
Is Communicable
No, a subperiosteal hematoma is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Careful handling of infants, especially newborns, to prevent head trauma.
Protective headgear for children participating in sports or activities with a risk of head injury.
Ensure safe environments for children to reduce the risk of falls.
Monitor the hematoma for signs of infection (redness, warmth, pus) or increasing size.
Consult a physician for proper diagnosis and management.
How long does an outbreak last?
Subperiosteal hematomas are not an outbreak-related condition. They are typically isolated events caused by trauma. The resolution time varies. Small hematomas may resolve within a few weeks. Larger hematomas can take several months to resolve completely.
How is it diagnosed?
Physical examination: Assessing the characteristics of the swelling.
Medical history: Gathering information about the circumstances of the injury or birth.
Skull X-rays: To rule out fractures (though not always necessary).
Ultrasound: Can help confirm the presence of a fluid collection.
CT scan or MRI: May be performed in certain situations, such as to evaluate for underlying skull fractures or intracranial injuries, especially in cases of significant trauma.
Timeline of Symptoms
9. Timeline of symptoms
Immediately after the injury or birth: Swelling may be apparent or may develop within the first few hours.
First few days: The swelling may increase in size. Bruising may become visible.
Over the next few weeks to months: The swelling gradually decreases in size as the blood is reabsorbed.
Complete resolution: The hematoma disappears completely, typically within a few weeks to several months.
Important Considerations
Differentiation from other conditions: It's important to differentiate a subperiosteal hematoma from other scalp swellings, such as caput succedaneum or cephalohematoma. Caput succedaneum crosses suture lines, while cephalohematoma is beneath the periosteum but takes longer to develop.
Rare Complications: While most subperiosteal hematomas resolve without complications, potential risks include infection, calcification of the hematoma, or, very rarely, significant blood loss.
Monitoring: Regular monitoring by a healthcare provider is important to ensure proper healing and to detect any potential complications.
Parental Education: Parents should be educated about the expected course of the hematoma and what signs to watch out for that would warrant medical attention.