The practice of pediatrics . al and uncomplicated labors. Joret observedcephalhematoma upon the occipital bone in children born in breechpresentation. Pfeiffer reports 38 cases of cephalhematoma deliveredin breech presentation and 15 in vertex presentation, and among them4 forceps deliveries; 12 cases of breech presentation terminated sponta-neously. By internal hematoma is commonly meant an accumulation of bloodbeneath the internal pericranium. The existence of this conditioncannot be demonstrated during life, but can be inferred from theexistence of an external hematoma with pressure symptom
The practice of pediatrics . al and uncomplicated labors. Joret observedcephalhematoma upon the occipital bone in children born in breechpresentation. Pfeiffer reports 38 cases of cephalhematoma deliveredin breech presentation and 15 in vertex presentation, and among them4 forceps deliveries; 12 cases of breech presentation terminated sponta-neously. By internal hematoma is commonly meant an accumulation of bloodbeneath the internal pericranium. The existence of this conditioncannot be demonstrated during life, but can be inferred from theexistence of an external hematoma with pressure symptoms. (41) 42 DISEASES AND INJURIES OF THE NEWBORN Hematoma of the sternocleidomastoid muscle occurs more frequentlyon the right side than on the left, and in breech than in occipital presen-tations. It is due to pressure ami twisting of the head at birth. Thehematoma is situated in the belly of the muscle and is very may be accompanied by rupture of some of the muscle fibres andinflammation of the muscle sheath. Fig. 9. Rupture of diaphragm; intestine in thorax. Anterior view. The prognosis is good, although several weeks may pass before theswelling has disappeared, and a slight torticollis may be present duringthat time. No treatment is required in this form. Cases of caput obstipum musculare congenitum, or muscular torti-collis, differ from simple hematoma of the sternomastoid in that theyare caused by intrauterine malposition and pressure, which interferewith the circulation in the muscle and result in pressure atrophy. INJURY AT BIRTH 43 Microscopically, the muscle shows interstitial myositis. Operationalone can improve or cure such cases. Treatment.—In the treatment of cephalhematoma and hematoma ofthe sternocleidomastoid muscle it is of importance to notice whether thetumor is extending In cephalhematoma we recognize the limitation ofthe tumor by the distinct edge showing the margin of the pericranium. Fig. 10
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