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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.

Kevin Schreiber
SZMC, Israel
 
> On Mon, March 30, 2009
11:28 am EDT, Nelson, Stephen L LtCol USAF AETC 81 MDOS/SGOC
> wrote:
> 
> 
> 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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> 
>

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