Atretic cephalocele

Case contributed by Dr Dalia Ibrahim

Presentation

Palpable high parietal subgaleal mass

Patient Data

Age: 6 months old
Gender: Male
MRI

Mid-line subcutnous cystic lesion with vertically oriented primitive falcine vein pointing to the cephalocele.

MRI

Vertically oriented persistent falcine vein.

Fenestrated superior sagittal sinus at the site of the cephalocele.

Annotated image

Sagittal T2 WI shows:

Mid-line subcutaneous cystic lesion (atertic cephalocele) (AC),

Vertically oriented persistent primitive falcine vein (open arrow) & an adjacent hardly distinct thin fibrous stalk (solid arrow) are pointing to and connecting the cephalocele through the calvarial defect.

Prominent superior cerebellar cistern & suprapineal recess.

Axial T2 WI shows:

Fenestration of the superior sagittal sinus  (open arrows) surrounding the cephalocele fibrous stalk (Solid arrow)

Coronal T1 WI shows:

Peaked configuration of the tentorium.

Case Discussion

Atretic cephalocele Consists of:

  • Subgaleal mass with intracranial extension.
  • Vertical primitive falcine vein and fibrous tract point to the subcutanous scalp mass.
  • Focal fenestration of the superior sagittal sinus at the AC.

Differential diagnosis:

  • Sinus pericranii.
  • Dermoid or epidermoid sinus.
  • Sebaceous cyst.
  • Cephalhematoma.
  • Infantile hemangioma.

 

 

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Case information

rID: 28711
Case created: 8th Apr 2014
Last edited: 14th Nov 2015
Inclusion in quiz mode: Included

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