Atretic parietal cephaloceles (APC), also known as atretic cephaloceles, are small subscalp lesions that consist of dura, fibrous tissue, and dysplastic brain tissue.
Common presentation in infants and young children.
Palpable midline parietal soft tissue mass.
Increased incidence of intracranial anomalies.
- subgaleal soft tissue mass with an intracranial extension via a sharply demarcated calvarial defect (cranium bifidum)
- CSF tract and vertical falcine vein point to the subcutaneous scalp mass
- vertically oriented primitive falcine vein
- fibrous stalk connecting the cephalocele
- focal fenestration of superior sagittal sinus at the atretic parietal cephalocele
- prominence of the superior cerebellar cistern and suprapineal recess
- superior peaking of the posterior tentorium
- spinning top configuration of the tentorial incisura
Imaging differential considerations include
- sinus pericranii
- dermoid or epidermoid cyst
- sebaceous cyst
- vascular lesions (haemangioma)
Treatment and prognosis
The prognosis of atretic cephaloceles is generally good.
- 1. Osborn AG, Salzman KL, Barkovich AJ. Diagnostic Imaging: Brain. Lippincott Williams & Wilkins. (2009) ISBN:1931884722. Read it at Google Books - Find it at Amazon
- 2. Wong SL, Law HL, Tan S. Atretic cephalocele - an uncommon cause of cystic scalp mass. Malays J Med Sci. 2012;17 (3): 61-3. Free text at pubmed - Pubmed citation
- 3. Muralidharan CG, Aggarwal R, Singh D. Atretic parietal encephalocoele - An unusual diagnosis. Med J Armed Forces India. 2013;69 (1): 83-5. doi:10.1016/j.mjafi.2012.02.005 - Free text at pubmed - Pubmed citation