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.
Bathrocephaly is of no clinical significance 2 and typically resolves with skull remodelling 2. Occasionally it may persist in adults 3.
Rarely, there is an association with Hajdu-Cheney syndrome, which is characterized by hirsutism, joint laxity, acro-osteolysis, vertebral anomalies, bathrocephaly, and normal intelligence 4.
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 remodelling 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.
Treatment and prognosis
There is currently no evidence for intervention or surgical management of the disorder 1.
- 1. Justin Davanzo, Thomas Samson, R. Shane Tubbs, Elias Rizk. Bathrocephaly: a case report of a head shape associated with a persistent mendosal suture. (2019) Italian Journal of Anatomy and Embryology. 119 (3): 263-267. doi:10.13128/IJAE-15559
- 2. Kenneth F. Swaiman. Swaiman's Pediatric Neurology. (2019) ISBN: 9781437704358
- 3. Swischuk LE. Diagnóstico por imagens em neonatologia e pediatria. 3th ed. Rio de Janeiro, RJ: Livraria e editor Revinter. 1991: 851
- 4. Palav S, Vernekar J, Pereira S, Desai A. Hajdu-Cheney syndrome: a case report with review of literature. (2014) Journal of radiology case reports. 8 (9): 1-8. doi:10.3941/jrcr.v8i9.1833 - Pubmed
- 5. Dr. Emily R. Gallagher, Dr. Kelly N. Evans, Dr. Anne V. Hing, Dr. Michael L. Cunningham. Bathrocephaly: A Head Shape Associated with a Persistent Mendosal Suture:. (2013) The Cleft Palate-Craniofacial Journal. 50 (1): 104-8. doi:10.1597/11-153 - Pubmed
- 6. Alexander M. McKinney. Atlas of Normal Imaging Variations of the Brain, Skull, and Craniocervical Vasculature. (2017) ISBN: 9783319397900
- 7. Keats TE. An Atlas of Normal Roentgen Variants That May Simulate Disease. 2º ed. Chicago, IL: Year Book Medical Publishers, Inc. 1980: 52.
- 8. Caffey J. Pediatric X Ray Diagnosis. 6th ed. Chicago, IL: Year Book Medical Publishers, Inc. 1973: 14. (Alexander M. McKinney. Atlas of Normal Imaging Variations of the Brain, Skull, and Craniocervical Vasculature.