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.