Pediatric emergency medicine trisk 2491 2491
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hypothyroidism, rickets, or hydrocephalus. Increased intracranial pressure from
infection or hemorrhage produces a full or bulging fontanelle, whereas
dehydration produces a depressed fontanelle. A fontanelle that appears full while
the infant is supine or crying should be reassessed while the infant is held upright
and sleeping or feeding before it is determined to be full or bulging.
FIGURE 96.16 Caput succedaneum in a newborn infant. Large soft swelling over the vertex,
not confined to suture lines. (Courtesy of the late Peter Sol. In: Chung EK, Atkinson-McEvoy
LR, Boom JA, et al., eds. Visual Diagnosis and Treatment in Pediatrics . 2nd ed. Philadelphia,
PA: Lippincott Williams & Wilkins; 2010. With permission.)
