Jan 2013|Vol 10|Iss 1

   
 
Case
 
   
A case of cephalhematoma
 

 

Dr. Md. Ismail Shaikh, BHMS
North Bengal Medical College & Hospital
PO: Sushrutanagar, Darjeeling
West Bengal – 734012
Mobile: 9434063563
E-mail: dr.misk80@yahoo.com

 
 
 

        A mother came to me with her son aged 5 months with a lump on the scalp She stated that the swelling was not observed, but within one month of birth reddish discoloration on the scalp appeared. Gradually it increased in size, looked like soft reddish cap and gradually became firm. At the age of 3 months the mother consulted a pediatrician , he diagnosed as Cephalhaematoma , advised her to drain the blood through surgical procedure but she did not wish to go through this type of treatment. The lump had developed with calcium deposit and it became firm. She presented the swelling since 4 months The lesion was Reddish, bloody, large, firm, painless.

Associated Complaints

i) Umbilical hernia which increase in size during crying since birth.
ii) Otorrhoea offensive, thick, yellowish color since 2 month.

The patient is the 2nd child of the mother and was delivered normally with the help of episiotomy, although the 1st child was delivered through caesarean section. At birth hematoma was not observed, but within a month reddish discoloration on the scalp appeared. Gradually it increased in size and looked like soft reddish cap and gradually became firm.

Family History

Father: – Bone tumor on the lower end of left femur.
Mother: – Ganglion on the both wrist joint.

Physical General

Thermal reaction - Chilly Patient.
Digestion– Poor, Hiccough lasting long and recurred frequently.
Intolerance - Nothing particulars.
Stool– Soft, yellowish in color.
Urine– Normal.
Sweat– Scanty.
Sleep- Disturbed.

Mental General

Weeps and quiet when carried.

Physical Examination

Emaciated, dark complexion. And Tongue is white coated
b) Local Examination: - Of the Hematoma,Reddish in color, large in size.
Firm, painless at touch;

Diagnosis

    Calcified Cephalhematoma.

Miasmatic Consideration

i) Weeps and quiet when carried: - Psoric.
ii) Chilly Patient: - Psoric
iii) F/H of Bone tumor: – Syphilitic.
iv) F/H of Ganglion: – Sycotic.
v) Hiccough: - Psoric.
vi) Hematoma on the scalp: – Sycotic.
vii) Umbilical Hernia: - Sycotic.
viii) Otorrhoea: - Syphilitic.
(Psoric, Sycotic and Syphilitic, all three miasms are prominent)

Rubrics after evaluation of symptoms

i) Weeps and quiet when carried: - Mind, Weeping, Carried, Is quiet only when carried.
ii) Chilly patient: - Generalities, Cold, In general Agg.
iii) Hematoma on the scalp: - Head, Exotoses.
iv) Otorrhoea: - Ear, Discharges,
v) Umbilical Hernia: - Abdomen, Hernia, Umbilicus.
vi) Hiccough: - Stomach, Hiccough.

Repertorisation

First Prescription                    15.5.2011

I prescribed Calcarea Flouricum - 1M; this potency was chosen because of any child having more susceptibility and more the susceptibility more the higher potency required.

Follow up

Discussion
      Repertorization of this case indicates that the patient requires the medicine belonging to the Calcium family. There are few medicines available under calcium family which is more effective in case of blood tumor, cephalhematoma. Family history of the patient indicates that tendency to occur tumors/overgrowth in the family background. Thus, Calcium Flouride which is more effective in these cases than Calcium Carbonate was prescribed.

      Although the patient under Calcarea Carbonicum prepared from Calcium Carbonate may be present the guiding symptom of ‘Profuse sweat on the occiput, wetting the pillow’ and constitution as flabby muscles, large head and abdomen. This patient did not present with this type of symptom and constitution.

      As per repertorization, Calcarea Flouricum prepared from the Calcium Flouride got marks 9/4 and covers particulars general symptoms, also having all three miasmatic backgrounds and as per comparative material medica Calcarea Flouricum is the most appropriate medicine for this case.