A scalp swelling that does not cross suture lines and may take weeks to resolve is most consistent with which condition?

A scalp swelling that does not cross suture lines and may take weeks to resolve is most consistent with which condition?

• A. Cephalohematoma
• B. Caput succedaneum
• C. Subgaleal hemorrhage
• D. Molding

Answer: (A)

A key distinction with newborn scalp swellings is whether the swelling crosses the skull sutures. A cephalohematoma is a collection of blood between the bone and its periosteum, so it remains confined to a single cranial bone and does not cross suture lines. Because it’s a slow reabsorbing subperiosteal bleed, it can take weeks to resolve. In contrast, caput succedaneum is generalized scalp edema that does cross sutures, appears at birth, and typically resolves within a few days. A subgaleal hemorrhage involves bleeding under the scalp’s tough layers and can spread across sutures, often presenting as a diffuse and potentially life-threatening condition. Molding is the gradual overlapping of the skull bones during birth, not a separate swelling. Therefore, the described swelling most consistently fits cephalohematoma.

A key distinction with newborn scalp swellings is whether the swelling crosses the skull sutures. A cephalohematoma is a collection of blood between the bone and its periosteum, so it remains confined to a single cranial bone and does not cross suture lines. Because it’s a slow reabsorbing subperiosteal bleed, it can take weeks to resolve. In contrast, caput succedaneum is generalized scalp edema that does cross sutures, appears at birth, and typically resolves within a few days. A subgaleal hemorrhage involves bleeding under the scalp’s tough layers and can spread across sutures, often presenting as a diffuse and potentially life-threatening condition. Molding is the gradual overlapping of the skull bones during birth, not a separate swelling. Therefore, the described swelling most consistently fits cephalohematoma.