Patient's question:
Newborn, born on April 3rd, weighing 8.72 pounds at birth, delivered vaginally with forceps assistance. There was a hematoma on the upper right side of the brain at birth, approximately 982 cm in size. Both obstetricians and neonatologists recommend natural resolution of the hematoma, as aspiration is discouraged to avoid infection, and no measures have been taken so far. The hematoma is currently fading slowly.Previous treatment and outcomes: Jaundice appeared on the third day after birth, with urine tests to rule out hemolysis and a brain CT scan to rule out intracranial hemorrhage. Subsequently, blue light therapy was administered five times to resolve the jaundice, which has now subsided.
Desired assistance: If aspiration is performed, what is the optimal timing? Will anesthesia and antibiotics be used during aspiration? Will the scalp develop wrinkles after aspiration at the hematoma site? Has your hospital performed similar surgeries? Approximately how many cases have been done, and what is the overall success rate? Can the head shape of the child be completely restored to normal after hematoma aspiration, as if no hematoma had occurred?
If aspiration is performed at your hospital, under normal circumstances, what is the approximate length of hospital stay, and what are the estimated costs?
Doctor's answer:
1. In the initial stage of hematoma, local cold compress can be applied to prevent the hematoma from shrinking.2. For large hematomas, X-ray imaging should be performed for a thorough examination to understand if there is cranial bone damage. Blood should be drawn to test coagulation function, and if abnormalities are found, additional treatment should be provided promptly.
Advice:
1. Let the cranial hematoma naturally resolve. Avoid rubbing the hematoma and do not attempt to draw blood from it to prevent infection. If infection occurs and forms an abscess, it should be drained promptly through incision.
2. Children with hematomas should be moved as little as possible, positioned in a semi-recumbent position on the healthy side. For large hematomas, artificial feeding can be tried.