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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.

Steve

Stephen L Nelson, Lt Col, USAF, MC
MD, PhD, FAAP
Chief, Pediatric Neurology
301 Fisher St.
Keesler Medical Center
Keesler AFB, MS 39534
228-376-4412
 
-----Original Message-----
From: Pediatric Emergency Medicine Discussion List
[mailto:[log in to unmask]] On Behalf Of don zweig
Sent: Monday, March 30, 2009 9:42 AM
To: [log in to unmask]
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?

don

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