Atretic parietal cephalocele

Last revised by Dalia Ibrahim on 8 Oct 2022

Atretic parietal cephaloceles, 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.

Atretic parietal cephaloceles are thought to represent involuted true cephalocele (meningocele or encephalocele) connected to the dura mater via a fibrous stalk. 

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:

The prognosis of atretic cephaloceles is generally good.

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: occipital
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  • Case 4
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  • Case 5: atretic occipital cephalocele
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