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Radiological Case of the Month

Nestor B. Ilagan, MD; Burt T. Weyhing, MD; Key-Chyang Liang, MD; Sophie J. Womack, MD
Arch Pediatr Adolesc Med. 1994;148(1):65-66. doi:10.1001/archpedi.1994.02170010067015.
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A4020-g BLACK female was born to a 32-year-old, gravida 2, para 0, aborta 1 mother in a vacuum-assisted vaginal delivery after oxytocin was administered. Before delivery, manual rotation of the fetal head from the left occiput posterior position to the left occiput anterior position was performed. At 8 to 9 cm of cervical dilatation, the fetus had prolonged bradycardia leading to vacuum application. Apgar scores were 7/9 at 1 and 5 minutes.

Physical examination demonstrated a pale infant with a discolored, fluctuant mass over the right occipitoparietal area. The neonate was found to have a pulse of 160 beats per minute, respirations of 60 per minute, and a blood pressure of 54/32 mm Hg. Laboratory evaluation showed a hemoglobin level of 114 g/L, a hematocrit of 0.32, and a platelet count of 1.67×109/L. The infant received phytonadione.

In the first hours of life, the indurated area involved the


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