Management of Cephalohematoma: A Reference Center Experience and Description of a Refined Surgical Technique

Vollständiger Abstract

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Backround: Cephalohematoma is a common perinatal complication that typically resolves spontaneously. However, persistent cases may progress to calcification from the periphery toward the center of the hematoma after 4 weeks, resulting in cranial asymmetry and aesthetic deformity. There is currently no global consensus on the optimal timing and method of intervention. Methods: We analyzed the experience of a craniofacial reference center in Medellín, Colombia, in the management of both non-calcified and calcified cephalohematomas. Acute cases were initially observed. Persistent fluid collections were managed via percutaneous aspiration. Early “egg-shell” ossifications underwent minimally invasive removal, while mature calcified lesions with significant asymmetry were treated via craniotomy and tangential burring at approximately 12 months of age. Results: Twenty-two patients underwent percutaneous aspiration without complications or residual deformity. Seven patients with calcified cephalohematoma underwent surgical correction (mean age: 11 months). The mean operative time was 201 minutes, with a mean estimated blood loss (EBL) of 15 mL. No blood transfusions, infections, or reoperations were required. All patients achieved satisfactory aesthetic outcomes at 12-month follow-up. Conclusion: A staged management algorithm—ranging from aspiration to a specialized craniotomy and burring technique—provides safe, reproducible, and aesthetically satisfactory results for cephalohematoma at various stages of evolution.