Atretic cephalocele

Case contributed by Dalia Ibrahim

Presentation

Palpable high parietal subgaleal mass

Patient Data

Age: 6 months
Gender: Male
mri
This study is a stack
Sagittal
T2
This study is a stack
Axial
T2
This study is a stack
Axial
T1
This study is a stack
Axial
FLAIR
This study is a stack
Coronal
T1
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Info

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

mri
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Info

Vertically oriented persistent falcine vein.

Fenestrated superior sagittal sinus at the site of the cephalocele.

Annotated image
Sagittal
T2 WI
Axial
T2 WI
Coronal
T1 WI
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Info

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 subcutaneous scalp mass.
  • focal fenestration of the superior sagittal sinus at the AC.

Differential diagnosis:

 

 

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