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A 9-day-old male child born to a 24-year-old mother with three previous healthy children (one boy and two girls) was admitted with gradually increasing swellings over both parietal regions (figure 1), which was noticed on day 3 of life. He was a full-term normal vaginal delivery after an uneventful antenatal period, weighing 2.5 kg. The cutting of the umbilical cord was not associated with excessive bleeding. Vitamin K had been given intramuscularly at birth. A physical examination revealed a haemodynamically stable but pale baby with bilaterally symmetrically soft, fluctuant swellings measuring 3.5–4 cm in diameter over the parietal scalp regions. The rest of the examination was within normal limits. There was no evidence of bleeding from any other site or family history of bleeding tendencies.
How do you differentiate between the diagnoses below?
Subgaleal cerebrospinal fluid (CSF) collection
C. Cephalohaematoma. Caput succedaneum is a boggy, diffuse subcutaneous scalp swelling that has poorly defined margins and can extend over the suture lines. It is usually associated with moulding of head. A subgaleal bleed is a massive fluctuant swelling, and can extend from the orbital ridges to the nape of the neck. It is …
Contributors NKD was involved in management of patient, designing of case report and drafting the manuscript. RNN and NKK were involved in the review of literature, and will act as guarantors. The final manuscript was approved by all the authors.
Competing interests None declared.
Patient consent Obtained.
Ethics approval Institutional Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.