A novel management for calcifying cephalohematoma

Cephalohematoma, defined as a collection of blood between the skull and the pericranium bound by cranial suture borders, is usually associated with birth trauma. While many undergo spontaneous resolution, some persist and become calcified. Historical treatments for these lesions include observation, drainage, and surgical intervention. We propose a novel treatment method for cephalohematomas: passive cranial molding-helmet therapy. The two cases reported in this article illustrate that passive molding-helmet therapy can be an effective treatment for cephalohematoma in its early stages. Studies of plagiocephalic patients have demonstrated that cranial bones remain malleable and respond to molding-helmet therapy until an average age of 12 months; we applied that reasoning in our decision to treat our cephalohematoma patients. As in plagiocephalic patients, our two cases have shown that while strict adherence to a treatment regimen (case 1) results in a better cosmetic outcome, loose adherence to a treatment regimen (case 2) will also result in an acceptable cosmetic outcome. For children older than 12 months who present with calcifying hematomas, we anticipate molding-helmet therapy would be less effective because of cranial mineralization and subsequent rigidity, and believe surgery would be the most effective treatment past that point. This is consistent with experience gained from treating patients with deformational plagiocephaly with passive molding-helmet therapy? In two cases, cranial molding helmets have been used successfully to reshape the skull deformation caused by cephalohematoma. Further experience is needed to determine the optimum time of intervention, the length of intervention, and the extent of the possible outcome.