Although not present at birth, cephalohematomas appear within the first 24 hours and are due to subperiosteal hemorrhage involving the outer table of one of the cranial bones. The swelling, as above, does not extend across a suture, though it is occasionally bilateral following a difficult delivery. The swelling is initially soft, then develops a raised bony margin within a few days due to calcium deposits at the edge of the periosteum, and tends to resolve within several weeks.
In hydrocephaly, the anterior fontanelle is bulging and the eyes may be deviated downward, revealing the upper scleras and creating the "settingsun" sign, as shown in the figure above. The setting sun sign is also seen briefly in some normal newborns. (From Zitelli, BJ & Davis, HW. , Atlas of Pediatric Physical Diagnosis, 3rd ed., St. Louis: Mosby-Year Book. Courtesy of Dr. Albert Briglan, Children's Hospital of Pittsburgh.)
Scaphocephaly Frontal plagiocephaly
(sagittal) (unilateral coronal)
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