ERNST & YOUNG
Birth injuries are not uncommon, although most do not result in severe injury. However, your baby’s head can be particularly vulnerable to damage, and birth injuries involving head injuries and brain damage can be amongst the most devastating. While lack of oxygen cause some brain injuries, direct head injury can absolutely happen. Head injuries commonly occur during complicated vaginal birth when the child spends longer in the birth canal with improper use of forceps or vacuum assistance. Here are some of the more common ones.
Cephalohematoma Causing Head Injuries
A cephalohematoma sounds awful, but is actually pretty minor. Sometimes, a small amount of blood will pool just underneath the skin of the scalp. This occurs in the periosteum area of the skull, that is the tissue membrane that surrounds it. This is visible as a protrusion or bulge on the back of the head that appears soon after birth and feels soft. It then becomes hard and eventually goes away.
Cephalohematomas occur in about 1 to 2% of normal vaginal deliveries and about 3 to 4% of forceps or vacuum assisted deliveries. They are not harmful and will disappear on their own. However, head injuries are sometimes associated with jaundice or anemia, so have your baby checked over. Rarely, the cephalohematoma may become infected. In the majority of cases, though, it will just go away.
A similar, but much more serious issue is a subgaleal hematoma. In this case, the blood is pooling in the space between the skull and the scalp. Though rarer, it covers a greater area; while a cephalohematoma is fairly small, a subgaleal hematoma may spread across the entire skull. It’s caused by a rupture of the veins around the skull.
This can trigger permanent damage to the brain as well as significant blood loss, which can require a blood transfusion. In some cases, this is a warning sign of a coagulation disorder. However, the more common cause of a subgaleal hematoma is incorrect use of vacuum or forceps during a difficult delivery.
This literally means water on the brain, but what is actually going on is that cerebrospinal fluid has flooded the cavities of the brain. This is another thing which is often caused by external trauma during childbirth, although hydrocephalus can also be genetic. X-linked hydrocephalus is a rare genetic abnormality causing head injuries. Finally, it sometimes occurs in premature babies because of lack of development of the blood vessels.
Like subgaleal hematoma, it is generally caused by excessive force applied to the baby’s skull. The only treatment for hydrocephalus is complicated, very high risk, and expensive surgery. Without surgery, hydrocephalus can cause permanent damage to your child’s periventricular white matter. While most babies with hydrocephalus have a normal lifespan, only about half have normal intelligence, and there is a high risk of intellectual disability.
Caput Succedaneum Causing Head Injuries
This is a common, but fortunately mild complication. Sometimes the pressures put on the head of the baby as it passes through the birth canal or during an assisted delivery can result in swelling of the head or scalp. This generally resolves on its own and does not cause any kind of permanent damage, although in some cases medical treatment is needed and, like cephalohematoma, it can increase the risk of jaundice.
Caput succedaneum is identified by puffiness under the scalp, with the skin being swollen and soft. Usually, it’s worse on the side of the skull that comes out first.
Rarely, the use of forceps or poor positioning of the child in utero can cause a skull fracture. Skull fractures occur due to the pressure of the birth canal itself.
The most minor is a linear skull fracture, which is a simple break. This is usually not too serious unless it causes underlying bleeding. Infants may also experience a diastatic skull fracture, which occurs along the sutures, and can expand as the child grows, causing damage. Most serious are depressed skull fractures, which cause the skull to sink inwards. These are the most likely to be caused by incorrect use of instruments.
Professionals may not detect small linear fractures and tend to heal normally. Diastatic fractures also usually heal on their own, but should be monitored. A depressed fracture may show as a misshapen appearance for head injuries. Fractures can cause brain damage, which can result in seizures and listlessness. However, most infants recover and are fine and the majority don’t even need treatment.
An infant’s skull is actually pretty soft and flexible. The skull does not finish growing and closing until after birth. In fact, if you touch the top of your baby’s head, you can feel soft spots that map to the anterior and posterior fontanelles, where skull bones have yet to come into contact.
It’s perfectly normal for your child’s head to change shape as it comes down the birth control. The head will temporarily become more oblong or pointed. The head molding is not a birth complication or injury and, in fact, is helpful by allowing the head to shape to the birth canal. Your child’s head will return to a more normal shape after a few days. Children who are born breech do not have head molding.
Head molding is not anything to worry about and can easily be distinguished from an actual deformity.
In some cases, head injuries at birth are the result of a genetic condition or simple trauma from the birth canal. Some are not worth worrying about, such as cephalohematoma. Others can have a significant impact on your child’s life.
Learn More About Head Injuries During Birth
Incorrect use of forceps or vacuum assistance can be a direct cause of head injuries, and potentially of brain damage and long term disability. If you suspect that your child’s head injury occurred due to improper use of tools during an assisted delivery, you may have a case for medical malpractice. Contact Weltchek, Mallahan, and Weltchek to find out how we can help you. As experienced medical malpractice lawyers, we help you and your family receive fair compensation for your child’s head injury.
Who Can You Trust with Your Case?
Have you or a loved one been injured due to negligence? We want to help. Don’t hesitate to contact us if you believe you have a case; time is an important factor. Interested in learning more? Get in touch with us so we can better evaluate and serve your needs in getting the justice your loved one deserves. You may very well be entitled to compensation.
Call For a Free Consultation