Birth is one of life’s most profound experiences, but complications during labor and delivery can lead to devastating injuries. Two serious types of head injuries in newborns are cephalohematomas and subgaleal hemorrhages. While both involve bleeding beneath the scalp, they differ in location, severity, and long-term consequences. These injuries are often associated with birth trauma, particularly when vacuum extractors or forceps are used.
If your child suffered a cephalohematoma or subgaleal hemorrhage due to negligent medical care, Hoffer & Sheremet’s experienced birth injury attorneys are here to help you seek justice and secure the compensation your family deserves.
What Is a Cephalohematoma?
A cephalohematoma is a collection of blood between a newborn’s skull bone and the periosteum (the membrane covering the bone). It usually occurs on one side of the head and is most often caused by pressure during delivery or the use of vacuum extractors or forceps.
Key Features:
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Location: Beneath the periosteum, confined to one skull bone (most often the parietal bone)
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Timing: May appear within hours after birth
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Causes: Prolonged labor, difficult vaginal delivery, or instrument-assisted delivery
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Appearance: A firm, well-defined swelling that does not cross suture lines
While many cephalohematomas resolve over weeks to months, they can lead to complications, including:
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Anemia (due to blood loss)
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Jaundice (as the blood in the hematoma breaks down)
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Infection (especially if the overlying skin is damaged)
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Calcification or skull deformity
What Is a Subgaleal Hemorrhage?
A subgaleal hemorrhage is a much more dangerous condition. It involves bleeding in the space between the scalp’s aponeurosis (a strong fibrous layer) and the skull. This space is large, meaning significant amounts of blood can accumulate quickly—sometimes up to a third of a newborn’s blood volume—making this a life-threatening emergency.
Key Features:
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Location: Between the scalp and skull, often extending across the entire head
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Causes: Most commonly vacuum extraction, but also difficult or traumatic deliveries
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Appearance: A boggy, rapidly enlarging scalp swelling that crosses suture lines
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Signs of severity: Pallor, low blood pressure, rapid heart rate, poor perfusion, and sometimes shock
Subgaleal hemorrhage requires immediate medical intervention. Delay in recognizing and treating this condition can lead to hypovolemic shock, brain injury, or death.
Causes of Cephalohematoma and Subgaleal Hemorrhage from Birth Trauma
These injuries are often linked to medical negligence, including:
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Improper use of vacuum extractors or forceps
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Excessive traction or twisting of the baby’s head
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Failure to monitor fetal distress and act appropriately
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Prolonged or obstructed labor without timely intervention
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Inadequate monitoring and delayed treatment of post-delivery bleeding
When these injuries occur due to poor medical decision-making, they may be grounds for a birth injury malpractice claim.
Long-Term Effects
While some cephalohematomas resolve without issue, complications like anemia, infection, and skull abnormalities can occur.
Subgaleal hemorrhages, on the other hand, carry a high risk of mortality and long-term neurological injury if not treated promptly. Survivors may experience:
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Developmental delays
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Seizure disorders
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Cerebral palsy (in severe cases of hypoxic injury)
How Are These Injuries Diagnosed?
Prompt diagnosis is critical. Physicians may use:
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Physical exam: To assess scalp swelling and neurological status
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Imaging studies: Ultrasound, CT, or MRI to determine the extent of bleeding
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Laboratory tests: To monitor hemoglobin, hematocrit, and bilirubin levels
Treatment for Neonatal Cephalohematoma and Subgaleal Hemorrhage
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Cephalohematomas often require observation and supportive care. In severe cases, treatment for anemia or jaundice may be necessary.
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Subgaleal hemorrhages are a medical emergency. Treatment may include:
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Blood transfusions to replace lost volume
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Intensive monitoring in a neonatal intensive care unit (NICU)
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Surgical intervention in rare cases
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Failure to promptly diagnose and treat subgaleal hemorrhage can result in catastrophic outcomes.
Can These Injuries Be Prevented?
Cephalohematoma and subgaleal hemorrhage might not always be preventable. Sometimes, health care providers need to act quickly to save a baby's life. However, some cases are preventable.
Preventative measures include:
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Proper assessment of labor progression and fetal position
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Avoiding unnecessary or excessive use of vacuum or forceps
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Timely decision-making for a C-section when delivery is not progressing safely
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Close post-delivery monitoring of infants at risk
Pursuing a Birth Injury Lawsuit
If your child suffered a cephalohematoma or subgaleal hemorrhage due to medical negligence, you may be entitled to compensation for:
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Medical expenses (immediate and long-term)
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Pain and suffering
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Future care needs
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Loss of quality of life
Our attorneys will work with medical experts to review your case, identify errors in care, and fight for the compensation your family needs.
Why Choose Hoffer & Sheremet
At Hoffer & Sheremet, PLC, we focus exclusively on medical malpractice and birth injury cases. Our team combines legal expertise with medical knowledge to build strong cases for our clients. We understand the profound impact these injuries have on families—and we fight tirelessly for justice.