Background:
Cephalhematoma is a frequent condition in newborn infants due to birth-related trauma(1), but ossified cephalhematoma (OCH) is a rare condition, especially when it presents as a skull lesion in the older pediatric population(2). OCH is located under the periosteum (pericranium), and the pericranium plays a crucial role in enveloping the organized hematoma by an ossified tissue(3). The previous history of a soft fluctuant mass just after the birth is the key to the diagnosis of OCH(4).
Chronic intradiploic hematoma (CIH) is another rare condition caused by an organized hematoma between the inner and outer tables of the skull. Differentiating CIH from OCH could be difficult for young neurosurgeons. CIH presents as a slow-growing skull mass. The exact pathogenesis is unclear, but repetitive bleeding in the intradiploic space initiated by trauma may be the leading cause(3).
We represent a case of OCH presented as a skull lesion managed with craniectomy and en-bloc excision of the organized hematoma. We will discuss the differences between OCH and CIH in diagnosis and management.