Last revised by Craig Hacking on 18 Apr 2023

Bathrocephaly, also known as bathrocephalic occiputs, is a normal variation in skull shape, caused by an outward convex bulge of mid-portion of the occipital bone, often associated with a modification of the mendosal suture.

The true incidence of this disorder is unknown 1.

Rarely, there is an association with Hajdu-Cheney syndrome, which is characterized by hirsutism, joint laxity, acro-osteolysisvertebral anomalies, bathrocephaly, and normal intelligence 4.

Bathrocephaly is of no clinical significance 2 and typically resolves with skull remodeling 2. Occasionally it may persist in adults 3.

Bathrocephalic occiputs is a normal variation in skull shape, in which there is an outward convex bulge of mid-portion of the occipital bone 5. Bathrocephaly extends from the lambdoid to the mendosal suture. There is often a significant bulge of the interparietal portion of the occipital bone 3,6.

The etiology of the condition is uncertain. Batrocephaly probably results from intrauterine modelling, with spontaneous remodeling being the rule 2,6. It can occur in babies who are a breech presentation in utero 2.

This disorder may be the result of incomplete fusion of the mendosal suture, which leads to bulging of the interparietal portion of the occipital bone. The skull protrusion slowly becomes less prominent and usually disappears 6. When it persists, it is associated with the characteristic head shape called bathrocephaly.

Radiographs show a step-like bony protrusion of the posterior skull, with prominent occipital shelf, which should not be confused with pathologic changes. It is not associated with craniosynostosis 2.

CT usually shows protrusion of the occipital bone between both parietal bones, with a step-like appearance of the occiput 6.

There is currently no evidence that intervention or surgical management of the disorder is necessary 1.

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Cases and figures

  • Case 1
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  • Case 2: with persistent mendosal suture
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