Location

Philadelphia, PA

Start Date

3-5-2023 1:00 PM

End Date

3-5-2023 4:00 PM

Description

Delayed subaponeurotic fluid collection (DSFC) is a rare cause of scalp swelling in infants presenting weeks to months after birth. DSFC is described as a mobile and soft swelling which crosses suture lines in healthy infants with no recent history of trauma or fall. A literature search in the National Library of Medicine revealed fewer than 15 publications on the topic since 2007. The exact etiology and long term consequences of DSFC remain unclear although birth trauma has been implicated as the main mechanism. A healthy 2 month old male infant presented to the ED with a one-day history of fluctuant painless occipito-parietal scalp mass with no erythema, pain, or recent injury. He was born at 37 weeks gestation from a nulliparous mother by induced vacuum assisted vaginal delivery secondary to gestational hypertension. The infant was born with a mild scalp vacuum mark and posterior caput succedaneum which resolved. There was no history of scalp injury at birth or recent head trauma. The infant presented to the ED well-appearing with no evidence of trauma or signs of distress. A noncontrast head CT showed a fluid collection crossing the midline. A definitive diagnosis of DSFC was carefully made after collaboration with multiple specialists. Although this condition is benign, it is important to make DSFC more well known to eliminate the need for unnecessary imaging, diagnostic studies, and overall distress.

Embargo Period

6-28-2023

Included in

Pediatrics Commons

COinS
 
May 3rd, 1:00 PM May 3rd, 4:00 PM

A rare case of scalp swelling in infancy: Delayed subaponeurotic fluid collection

Philadelphia, PA

Delayed subaponeurotic fluid collection (DSFC) is a rare cause of scalp swelling in infants presenting weeks to months after birth. DSFC is described as a mobile and soft swelling which crosses suture lines in healthy infants with no recent history of trauma or fall. A literature search in the National Library of Medicine revealed fewer than 15 publications on the topic since 2007. The exact etiology and long term consequences of DSFC remain unclear although birth trauma has been implicated as the main mechanism. A healthy 2 month old male infant presented to the ED with a one-day history of fluctuant painless occipito-parietal scalp mass with no erythema, pain, or recent injury. He was born at 37 weeks gestation from a nulliparous mother by induced vacuum assisted vaginal delivery secondary to gestational hypertension. The infant was born with a mild scalp vacuum mark and posterior caput succedaneum which resolved. There was no history of scalp injury at birth or recent head trauma. The infant presented to the ED well-appearing with no evidence of trauma or signs of distress. A noncontrast head CT showed a fluid collection crossing the midline. A definitive diagnosis of DSFC was carefully made after collaboration with multiple specialists. Although this condition is benign, it is important to make DSFC more well known to eliminate the need for unnecessary imaging, diagnostic studies, and overall distress.