I would also be concerned about the possibility of a growing skull fracture.
Was there any history of trauma prior to this episode? These may be meninges
buldging through a non healed linear skull fracture.
> On Mon, March 30, 2009
11:28 am EDT, Nelson, Stephen L LtCol USAF AETC 81 MDOS/SGOC
> Likely resolving
cephalohematoma from birth, can sometimes seem to "suddenly
appear" months later as they undergo breakdown. Check birth records and see
> if there was any noted scalp swelling, skull asymmetry.
> Stephen L Nelson, Lt Col, USAF, MC
> MD, PhD,
> Chief, Pediatric Neurology
> 301 Fisher St.
> Keesler AFB, MS 39534
> -----Original Message-----
> From: Pediatric Emergency Medicine
> [mailto:[log in to unmask]] On Behalf Of don
> Sent: Monday, March 30, 2009 9:42 AM
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> Subject: am i missing sumthin?
> 11 m old prev healthy girl brought in by two very appropriate
intelligent parents; sent in by pediatrician after seen for a soft
> spot on
left temp parietal portion of skull that began misteriously
> this am. they
are with child constantly and there has been no
> trauma. child is acting
normal and is playful and into everything and
> very cute. there is no nv.
on exam she has a surprise temp of 38.7 r
> and other vitals normal but no
bp taken. she has a normal fontanel
> but on the left side of scalp is an
area maybe 3x3 inch of non tender
> soft fluid filled area like a hematoma
but no discoloration/tenderness
> or abrasion. no battles raccoon and the
remainder exam is entirely
> normal. what would you do?
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