{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:10:36Z","timestamp":1787314236308,"version":"build-2736575974"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,10]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Spontaneous subaponeurotic fluid collection (SSFC) is an uncommon and newly described entity of unknown etiology, observed in infants less than 1 year of age. The authors report on series of infants who presented to the Hospital for Sick Children (HSC) with SSFC, focusing on the natural history of this condition.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Data from the Hospital for Sick Children were retrospectively reviewed for the period between January 2004 and June 2015. Patient age and sex, birth history, medical history, laboratory findings, and symptoms were reviewed. SSFC location, imaging characteristics, management, and outcome were also analyzed. A MEDLINE and Embase literature search was performed on the condition, yielding previously reported cases of SSFC in the English language.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Nine cases involving patients who presented with SSFC during the study period were identified. The patients were 4 male and 5 female infants (age range 5 weeks to 11 months). All cases of SSFC developed spontaneously over a period of days, and the infants had no history of injuries, trauma, or hair manipulation in the immediate period preceding the development of the subgaleal collections. Six patients underwent remote forceps- or vacuum-assisted instrumented births, although none of the patients developed scalp collections or skin discoloration immediately after birth. All of the cases were managed conservatively on an outpatient (6 cases) or inpatient (3 cases) basis. In 1 case, the size of the fluid collection fluctuated over 4 months, but in all of the cases, the collections resolved spontaneously without structural or infectious complications.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n This is the largest series describing SSFC to date and summarizes 9 cases managed at a large academic neurosurgical center. Although the specific pathophysiology of SSFC remains unknown, in some cases the condition may be associated with a remote history of instrumented delivery. SSFC occurs spontaneously without immediate preceding trauma, and an extensive hematology or child abuse workup is not necessary. A conservative approach with outpatient follow-up is advocated.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.4.peds1641","type":"journal-article","created":{"date-parts":[[2016,7,8]],"date-time":"2016-07-08T08:58:47Z","timestamp":1467968327000},"page":"442-447","source":"Crossref","is-referenced-by-count":19,"title":["Management and outcome of spontaneous subaponeurotic fluid collections in infants: the Hospital for Sick Children experience and review of the literature"],"prefix":"10.3171","volume":"18","author":[{"given":"Shelly","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario, Canada;"},{"name":"Departments of Biostatistics and Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Drake","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario, Canada;"},{"name":"Department of Surgery, Division of Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhaya V.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario, Canada;"},{"name":"Department of Surgery, Division of Neurosurgery, and"},{"name":"Pediatric Gamma Knife Program, Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds1641","series-title":"Pediatric Oncall","article-title":"Delayed extensive subgaleal hematoma following minor head injury","volume":"3","author":"Agrawal","year":"2006"},{"key":"b2-peds1641","series-title":"J Paediatr Child Health","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1111\/j.1440-1754.1996.tb01559.x","article-title":"Neonatal subgaleal haematoma: associated risk factors, complications and outcome","volume":"32","author":"Chadwick","year":"1996"},{"key":"b3-peds1641","series-title":"Lancet","first-page":"559","article-title":"Complications of fetal spiral electrodes","volume":"1","author":"Goodlin","year":"1973"},{"key":"b4-peds1641","series-title":"Clin Radiol","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1053\/crad.2001.0727","article-title":"Sub-aponeurotic fluid collections in infancy","volume":"57","author":"Hopkins","year":"2002"},{"key":"b5-peds1641","series-title":"Arch Dis Child Fetal Neonatal Ed","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1136\/archdischild-2012-302478","article-title":"An unusual swelling on an infant's head","volume":"98","author":"McAloon","year":"2013"},{"key":"b6-peds1641","series-title":"BMJ Case Rep","doi-asserted-by":"publisher","first-page":"bcr2013203457","DOI":"10.1136\/bcr-2013-203457","article-title":"Delayed subaponeurotic (subgaleal) fluid collection","volume":"2014","author":"Medows","year":"2014"},{"key":"b7-peds1641","series-title":"Am J Obstet Gynecol","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/0002-9378(83)90053-4","article-title":"Cerebrospinal fluid leak in a neonate associated with fetal scalp electrode monitoring","volume":"147","author":"Nieburg","year":"1983"},{"key":"b8-peds1641","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"34","DOI":"10.4103\/2152-7806.66622","article-title":"Delayed sub-aponeurotic fluid collections in infancy: Three cases and a review of the literature","volume":"1","author":"Petraglia","year":"2010"},{"key":"b9-peds1641","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1001\/jama.1980.03310140055031","article-title":"Subgaleal hematoma. A complication of instrumental delivery","volume":"244","author":"Plauch\u00e9","year":"1980"},{"key":"b10-peds1641","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.ejogrb.2014.07.027","article-title":"Sub-aponeurotic fluid collection in a neonate associated with fetal scalp electrode monitoring: a brief communication","volume":"181","author":"Roy","year":"2014"},{"key":"b11-peds1641","series-title":"Eur J Paediatr Neurol","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/j.ejpn.2007.10.010","article-title":"Sub-aponeurotic fluid collections: a delayed-onset self-limiting cerebrospinal fluid fistula in young infants","volume":"12","author":"Schoberer","year":"2008"},{"key":"b12-peds1641","series-title":"Isr J Med Sci","first-page":"633","article-title":"Cerebrospinal fluid leak in the neonate\u2014complication of fetal scalp electrode monitoring. Case report and review of the literature","volume":"26","author":"Sorokin","year":"1990"},{"key":"b13-peds1641","series-title":"Obstet Gynecol","first-page":"469","article-title":"Fetal scalp electrode complications: cerebrospinal fluid leak","volume":"54","author":"Turbeville","year":"1979"},{"key":"b14-peds1641","series-title":"BMJ Case Rep","first-page":"bcr0420102915","article-title":"Subaponeurotic or subgaleal fluid collections in infancy: an unusual but distinct cause of scalp swelling in infancy","volume":"2010","author":"Vaibhav","year":"2010"},{"key":"b15-peds1641","series-title":"J Am Board Fam Med","doi-asserted-by":"publisher","first-page":"750","DOI":"10.3122\/jabfm.2015.06.150080","article-title":"Experiences of parents caring for infants with rare scalp mass as identified through a disease-specific blog","volume":"28","author":"Worthen","year":"2015"}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/18\/4\/article-p442.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/18\/4\/article-p442.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/18\/4\/article-p442.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T09:09:52Z","timestamp":1681549792000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/18\/4\/article-p442.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10]]},"references-count":15,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2016.4.peds1641","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10]]}}}