[A case of epidural hematoma caused by a vacuum extraction without any skull fractures and accompanied by cephalohematoma]

Abstract

A case of epidural hematoma associated with cephalohematoma caused by a vacuum extraction was reported. Old liquefied hematoma was removed via a small burr hole in the parietal bone at the age of 23 days. No neurological deficits were recognized at the age of 6 months. As the dura mater does not easily detach from the overlying skull in the neonate, it is a very rare occurrence for this to happen as a complication of the use of forceps or in extractions. To our knowledge, only 4 cases of epidural hematoma after vacuum extraction have been reported. The mechanism of the development of an acute epidural hematoma during extraction is reported to be due to direct force to the dura mater and skull induced by negative pressure of a vacuum extraction. In the present case, it seems that negative pressure produced a detachment of the dura mater from the overlying skull. It suggests that examinations including plain craniogram and CT scan should be performed as soon as possible in the neonate with cephalohematoma when they have been delivered by a vacuum extraction.