Atretic parietal cephaloceles, also known as atretic cephaloceles, are small subscalp lesions that consist of dura, fibrous tissue, and dysplastic brain tissue.
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Epidemiology
Common presentation in infants and young children.
Clinical presentation
Palpable midline parietal soft tissue mass.
Pathology
Atretic parietal cephaloceles are thought to represent involuted true cephalocele (meningocele or encephalocele) connected to the dura mater via a fibrous stalk.
Associations
Increased incidence of intracranial anomalies.
Radiographic features
- 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
Differential diagnosis
Imaging differential considerations include:
- sinus pericranii
- dermoid or epidermoid cyst
- cephalohematoma
- sebaceous cyst
- vascular lesions (hemangioma)
Treatment and prognosis
The prognosis of atretic cephaloceles is generally good.
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