Differences between Caput Succedaneum and Cephalohematoma

On some occasions, depending on the course of delivery, newborns may present with head injuries called caput succedaneum and cephalohematoma. Both lesions are accumulations of blood located under the scalp, which are caused by hemorrhage in the extracranial soft tissues. This type of injury can be diagnosed on physical examination but should not be confused with each other, since their management is different.

For this reason, in this article we will present the definitions and characteristics of caput succedaneum and cephalohematoma, in order to determine the differences that arise from them.

Caput Succedaneum

The term caput succedaneum comes from a Latin word that means “substituted head” and refers to an extracranial subcutaneous serosanguineous accumulation of fluid that does not have defined margins. This is located outside the bony sheath, that is, extraperiosteal and occurs more frequently in the part of the head that presents first in childbirth, and may occur for various reasons:

  • Due to an increase in the molding of the newborn’s head.
  • By pressure of the affected area.
  • When instruments are used to extract the newborn, such as forceps or suction cups.

Likewise, caput succedaneum is rarely complicated and usually resolves in a few days without treatment, although it requires observation and medical follow-up, because, in some cases, the disorder can cause irritability in the newborn and may require treatment with analgesics to mitigate the symptoms. discomfort while in other less common cases, the skin may present bruises or redness.


The term cephalohematoma refers to hematomas that occur in the head area of ​​newborns. Therefore, it is an accumulation of blood located under the scalp, which is produced by a subperiosteal hemorrhage (below the outer layer of the periosteum that covers the flat bones of the skull).

Likewise, the cephalohematoma is characterized by having well-defined limits, since, as the hematoma is confined under the layer that covers the skull bones, it does not exceed the limits of the bone and therefore does not jump the sutures that define a bone of the skull. other. Additionally, cephalohematoma may not be identified at birth but can be diagnosed within a few days of delivery, because it presents as a bulge on the baby’s head that often worries parents.

Despite this, the cephalohematoma usually disappears spontaneously and usually lasts between two weeks and two or three months before it disappears, not requiring specific treatments, except in very few cases in which the cephalohematoma is very extensive. In other very specific cases, once the cephalohematoma disappears, a transitory hyperostosis (bulging of the bone) may remain, which over time tends to remodel itself to give way to the restoration of the normal architecture of the baby’s head.

In accordance with the above, the following differences between the corresponding terms are presented below:

  • The Caput Succedaneum begins at the time of delivery while the cephalohematoma begins hours or days after delivery.
  • The Caput Succedaneum usually disappears in a few days while the cephalohematoma usually disappears in weeks or months.
  • The Caput Succedaneum usually presents ecchymosis and reddening of the skin while the cephalohematoma does not usually present skin involvement.
  • Caput Succedaneum is an edema of extraperiosteal subcutaneous cellular tissue while cephalohematoma is a subperiosteal hemorrhage.

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