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Newborn with failure to progress during delivery due to dystocia who is now apneic

CT of caput succedaneum
Axial CT without contrast of the brain shows a cresenteric high-density fluid collection in the subcutaneous tissues of the right scalp that crosses suture lines and a cresenteric low-density fluid collection in the subcutaneous tissues of the left scalp that crosses suture lines. Intracranially, there is diffuse loss of gray matter-white matter differentiation secondary to diffuse cerebral edema.

The diagnosis was a left caput succedaneum and a right subgaleal hematoma in a patient with hypoxic ischemic encephalopathy.

Newborn who experienced prolonged labor

CT of caput succedaneum
Axial (above), coronal (below left) and sagittal (below right) CT without contrast of the brain show a large low density fluid collection in the subcutaneous tissues of the scalp that crosses sutures and is seen to surround the skull on the coronal view. Intracranially, there is diffuse loss of gray matter-white matter differentiation secondary to diffuse cerebral edema.

The diagnosis was caput succedaneum in a patient with hypoxic ischemic encephalopathy.

Newborn with an anterior chest wall defect including a split anterior half of the sternum, an omphalocele and a thoracoabdominal ectopic cordis

Surgical image of Pentalogy of Cantrell
Surgical image after the omphalocele sac was excised shows the apex of the heart (superiorly) and the liver (inferiorly). The pericardium was intact. The diaphragm was intact. The omphalocele was closed by approximating the abdominal fascia. The heart was covered with skin.

The diagnosis was Pentalogy of Cantrell.

Infant with a palpable ridge on the top of the head

Radiograph and 3D CT of sagittal craniosynostosis
AP (above left) and lateral (above right) radiographs of the skull show the skull to be lengthened (scaphocephaly / dolichocephaly). The sagittal suture appears sclerotic. Superior (below left) and lateral (below right) 3D CT reconstructions of the skull show the skull to be lengthened and complete fusion of the sagittal suture. The remaining sutures are patent.

The diagnosis was sagittal craniosynostosis.

Newborn with an unusual head shape

Radiograph and 3D CT of cloverleaf skull
AP (above left) and lateral (above right) radiographs of the skull and anterior (below left) and lateral (below right) 3D CT reconstructions of the skull show fusion of the bilateral coronal sutures, bilateral lambdoid sutures, metopic suture and anterior and posterior aspects of the sagittal suture. There is compensatory widening of the bilateral squamosal sutures. Hypotelorism is present and there are quizzical eye deformities present bilaterally.

The diagnosis was cloverleaf skull.