PURPOSE: Calcified cephalohematoma of infancy is a result of a subperiosteal blood collection, that usually forms during birth-related trauma. Calcified cephalohematomas can permanently deform the infant cranium, and significant deformities often require correction. Although several reconstructive techniques have been proposed, there is no consensus on their management. In this study, we present a technique for the excision and reconstruction of calcified cephalohematoma of the infant calvarium, in the context of long-term follow-up over the past 25 years.
METHODS: The charts of patients diagnosed with calcified cephalohematoma within our institution between 1994 and 2019 were reviewed. Only patients diagnosed by either our pediatric plastic surgeons or our pediatric neurosurgeons and had at least 3 months of follow-up were included. Patients underwent observation or surgery based on the recommendations of the surgical team. Patient demographics, imaging findings, and complications were reviewed.
RESULTS: We identified 160 infants with a diagnosis of cephalohematoma. Of those, 81 met inclusion criteria. Thirty-three patients with calcified cephalohematoma underwent surgical treatment. The mean age at diagnosis was 3.6 months, while the mean age at the time of surgery was 8.4 months. Of those who underwent surgery, 67% were male. Twenty-two surgical patients had a cranial defect requiring inlay bone grafting (66.7%). Six patients had perioperative blood loss requiring transfusion (18.2%) and 3 patients had postoperative complications (9.1%). Complications included superficial wound infection (n = 1) and postsurgical subgaleal hematoma (n = 2), treated successfully with bedside drainage.
CONCLUSION: Calcified cephalohematoma of infancy is rare entity that can cause significant deformity of the infant cranium. Over a 25-year period, our institution had 81 children with calcified cephalohematomas, with 33 necessitating surgical intervention. This is one of the largest series of calcified cephalohematomas to date. The technique presented herein was excellent for restoring normal cranial contours, while enjoying a low complication profile.