Two days after a difficult labour, a term newborn is noted to have a firm, tense swelling over the left parietal region bounded sharply by suture lines, without discolouration of the overlying scalp. The swelling had not been present immediately after birth. This lesion is:
- A Cephalhaematoma, due to bleeding between periosteum and bone ✓
- B Caput succedaneum, resolving within days
- C Subgaleal haemorrhage, requiring no follow-up
- D Depressed skull fracture needing urgent surgery in every case
Correct answer: A. Cephalhaematoma, due to bleeding between periosteum and bone
Explanation
B cephalhaematoma is subperiosteal bleeding, usually parietal, that is limited by suture lines, is absent at birth, appears over hours to days, and resolves slowly, sometimes with calcification. Caput succedaneum is present at birth, crosses suture lines, pits on pressure, and fades in days, which excludes option B. Subgaleal haemorrhage spreads across sutures beneath the galea and can cause life-threatening hypovolaemia, so it never respects sutures. Many depressed fractures need no surgery, making option D wrong.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.