title: Sagittal synostosis and ossified scalp hematoma: cause or consequence?
abstract: In this paper, the author presents 2 cases of sagittal synostosis with scaphocephaly that featured ossified scalp hematomas straddling the sagittal suture in the midparietal region. These ossified lesions were originally cephalohematomas. Collection of blood under the pericranium across the midline was possible in these cases because sagittal synostosis had obliterated the sagittal suture and its dense attachment to overlying periosteum. Scaphocephaly very likely exacerbated the difficulty of the deliveries and contributed to the causation of the scalp hemorrhages. The alternative hypothesis, that ossification of a scalp hematoma immobilized the suture and caused synostosis, is not tenable for reasons that are reviewed. Sagittal synostosis in these 2 instances was not a complication of birth trauma.
authors.affiliation: Section of Neurosurgery, Department of Pediatrics, Drexel University College of Medicine, St Christopher's Hospital for Children, Philadelphia, Pennsylvania, USA. jpiatt@nemours.org
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Piatt
mesh_terms: D003393:Cranial Sutures / Q000000981:diagnostic imaging*; D003398:Craniosynostoses / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery*; D003399:Craniotomy / Q000379:methods; D005500:Follow-Up Studies; D006406:Hematoma / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009999:Ossification, Heterotopic / Q000150:complications* / Q000000981:diagnostic imaging*; D010294:Parietal Bone / Q000000981:diagnostic imaging*; D012535:Scalp / Q000000981:diagnostic imaging* / Q000293:injuries; D013346:Subarachnoid Space / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects