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Copper beaten skull

Copper beaten skull (also known as beaten brass skull) refers to the prominence of convolutional markings (gyral impressions on the inner table of the skull) seen throughout the skull vault.

Demographics and clinical presentation

The appearance of copper beaten skull is associated with raised intracranial pressure in children. Convolutional markings may be normal, but are usually confined to the posterior part of the skull's inner table.

Pathology

Raised intracranial pressure is (at least in part) the causative mechanism behind increased inner table markings that give rise to the copper beaten skull appearance. Hence, pathology that causes raised intracranial pressure may be the primary cause of copper beaten skull; these include, but are not limited to:

Radiographic features

Rather than the inner table of the skull being smooth, there are convolutions that sit adjacent to the underlying gyri. As described above (and seen in the adjacent case), convolutional changes may be normal if they are confined to the posterior calvarium and are subtle.

3D volume rendered reformats demonstrate a calvarium with similar appearances to hand beaten copper pot bottoms.

Differential diagnosis

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