Rhodes Adam, Neuman Jeremy, Blau Jonathan
Department of Pediatrics, Staten Island University Hospital Northwell Health, Staten Island, NY, USA.
Department of Radiology, Staten Island University Hospital Northwell Health, Staten Island, NY, USA.
J Neonatal Perinatal Med. 2019;12(3):321-324. doi: 10.3233/NPM-1872.
Biophysical profile (BPP) with ultrasound performed for a 32-year-old G5P3013 admitted at 31 weeks gestation with preterm, premature rupture of membranes (PPROM) noted an extracalvarial mass concerning for an encephalocele. Fetal MRI demonstrated edema over the occiput with no definable lesion visualized. Preterm labor requiring Cesarean delivery resulted in a live male neonate at 33 weeks gestation. An occipital mass was observed on neonatal physical exam. Postnatal ultrasound and MRI were consistent with cephalohematoma. This was surprising given the lack of vaginal delivery. We hypothesize that the occiput was positioned against the maternal ischial tuberosity and developed chronic trauma secondary to normal fetal movement over time, resulting in a cephalohematoma. Postnatal imaging confirmed this diagnosis as the mass gradually decreased and ultimately resolved. Although other etiologies are possible, this case emphasizes the need to consider cephalohematoma in the differential of CNS masses during pregnancy without abdominal trauma and/or vaginal delivery.
对一名32岁、孕31周入院的G5P3013孕妇进行了生物物理评分（BPP）及超声检查，该孕妇胎膜早破（PPROM）早产，超声发现颅骨外有一肿块，怀疑为脑膨出。胎儿MRI显示枕部水肿，但未发现明确病变。因早产需剖宫产，孕33周时娩出一名活男婴。新生儿体格检查发现枕部有一肿块。产后超声和MRI检查结果与头皮血肿相符。鉴于未经历阴道分娩，这一结果令人惊讶。我们推测枕部抵靠母体坐骨结节，随着时间推移，因胎儿正常活动导致慢性创伤，从而形成头皮血肿。产后影像学检查证实了这一诊断，因为肿块逐渐减小并最终消失。尽管可能存在其他病因，但该病例强调了在孕期无腹部创伤和/或阴道分娩的情况下，鉴别中枢神经系统肿块时需考虑头皮血肿。
