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A rare cause of scalp swelling in infancy: delayed subaponeurotic fluid collections in five cases

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Abstract

Subaponeurotic (subgaleal) fluid collection (DSFC) is a rare clinical entity of unknown etiology. We aimed to present our series of infants who were diagnosed with DSCF at Ankara University Children’s Hospital. We retrospectively reviewed clinical findings, imaging studies, laboratory tests, management, and clinical courses of infants diagnosed with DSCF between June 2014 and June 2018. Five infants (4 males, 1 female), aged 5–14 weeks, were identified during the study period. All deliveries were non-progressive (3 normal deliveries, 2 cesarean sections) while instrumentation (vacuum extraction or forceps) was used in 2. History of recent trauma, concern for child abuse, and family or personal history of coagulopathy were negative for all patients. Conservative management with the spontaneous resolution was observed in 2 to 12 weeks in all infants. Although rare, DSFC should always be kept in mind in the differential diagnosis of scalp swelling in young infants. The diagnosis is primarily clinical, and current treatment is conservative.

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Abbreviations

DSFC:

Delayed subaponeurotic (subgaleal) fluid collection

CSF:

Cerebrospinal fluid

MRI:

Magnetic resonance imaging

US:

Ultrasonography

CS:

Cesarean section

CT:

Computed tomography

References

  1. Hopkins RE, Inward C, Chambers T, Grier D (2002) Sub-aponeurotic fluid collections in infancy. Clin Radiol 57(2):114–116

    Article  CAS  PubMed  Google Scholar 

  2. Worthen M, Leonard TH, Blair TR, Gupta N (2015) Experiences of parents caring for infants with rare scalp mass as identified through a disease-specific blog. J Am Board Fam Med 28(6):750–758. https://doi.org/10.3122/jabfm.2015.06.150080

    Article  PubMed  Google Scholar 

  3. Schoberer A, Yagmur E, Boltshauser E, Korinth M, Niggemann P, Häusler M (2008) Sub-aponeurotic fluid collections: a delayed-onset self-limiting cerebrospinal fluid fistula in young infants. Eur J Paediatr Neurol 12(5):401–403

    Article  PubMed  Google Scholar 

  4. Petraglia AL, Moravan MJ, Marky AH, Silberstein HJ (2010) Delayed sub-aponeurotic fluid collections in infancy: three cases and a review of the literature. Surg Neurol Int 1. https://doi.org/10.4103/2152-7806.66622

  5. Smith A, Kandamany N, Okafor I, Robinson I, Foran A, McNamara R (2016) Delayed infant subaponeurotic (subgaleal) fluid collections: a case series of 11 infants. Emerg Med 50(6):881–886. https://doi.org/10.1016/j.jemermed.2016.03.024

    Article  Google Scholar 

  6. Wang S, Drake J, Kulkarni AV (2016) Management and outcome of spontaneous subaponeurotic fluid collections in infants: the Hospital for Sick Children experience and review of the literature. J Neurosurg Pediatr 18(4):442–447

    Article  PubMed  Google Scholar 

  7. Medows M, Mohammad Nijres B (2014) Delayed subaponeurotic (subgaleal) fluid collection. BMJ Case Rep 2014. https://doi.org/10.1136/bcr-2013-203457

  8. Vaibhav A, Smith R, Millman G, Cooper J, Dwyer J (2010) Subaponeurotic or subgaleal fluid collections in infancy: an unusual but distinct cause of scalp swelling in infancy. BMJ Case Rep 2010. https://doi.org/10.1136/bcr.04.2010.2915

  9. Lee JJ, Wenger TL (2018) Delayed subaponeurotic fluid collections of infancy. J Pediatr 197:310–310.e1. https://doi.org/10.1016/j.jpeds.2018.01.083

    Article  PubMed  Google Scholar 

  10. Munjal S, Kumar S (2017) Subaponeurotic cerebrospinal fluid collection in an infant. J Pediatr Neurosci 12(3):271–272. https://doi.org/10.4103/jpn.JPN_19_17

    Article  PubMed  PubMed Central  Google Scholar 

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Contributions

EI and NECI designed the study. NECI had the primary responsibility in the formation of the initial draft. All authors provided substantial contributions to the design of the work and the acquisition or the interpretation of the data, revised the initial draft, approved the final manuscript, and agreed to be accountable for all aspects of the work.

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Correspondence to Nisa Eda Cullas Ilarslan.

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The authors declare no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cullas Ilarslan, N.E., Gunay, F., Kaynak, S.S. et al. A rare cause of scalp swelling in infancy: delayed subaponeurotic fluid collections in five cases. Childs Nerv Syst 35, 875–878 (2019). https://doi.org/10.1007/s00381-018-04040-9

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  • DOI: https://doi.org/10.1007/s00381-018-04040-9

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