Which finding differentiates caput succedaneum from cephalohematoma?

• A. Caput crosses sutures; cephalohematoma does not
• B. Cephalohematoma crosses sutures; caput does not
• C. Caput is above periosteum
• D. Cephalohematoma is below the scalp

Answer: (A)

Caput succedaneum and cephalohematoma differ in whether the swelling crosses the cranial sutures. Caput succedaneum is diffuse scalp edema that lies above the periosteum, so it easily spreads across suture lines and over the scalp. Cephalohematoma is a subperiosteal bleed beneath the periosteum; because the periosteum stays attached at the sutures, the swelling remains confined to a single bone and does not cross sutures. This crossing-versus-non-crossing distinction is what differentiates the two. Caput typically appears at birth and resolves within a few days, while cephalohematoma may appear hours after birth and can take weeks to months to resolve, sometimes with hyperbilirubinemia risk.