MRI features of an infected cephalhaematoma in a neonate.

Bacterial infection of a cephalhaematoma is rare and has been associated with needle aspiration of the haematoma, placement of scalp electrodes and systemic sepsis. Clinical diagnosis of infected cephalhaematoma is difficult without obvious evidence of local infection. The role of imaging in differentiating infected from non-infected cephalhaematoma has not been clearly established. Needle aspiration is considered mandatory for suspected cases. In this report, we present the magnetic resonance imaging (MRI) findings of a 23-day-old neonate with an infected cephalhaematoma. Cephalhaematoma is a subperiosteal accumulation of blood, thus the diagnosis of infected cephalhaematoma was made as the MRI showed an accumulation of blood under thick, contrast-enhancing periosteum in the presented case. Without a diagnostic puncture, the decision for surgical intervention was made before complicating osteomyelitis developed. Early intervention with simple incision and drainage resulted in prompt improvement.