Atretic parietal cephalocele
A palpable scalp mass
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Midline subgaleal cystic mass at the posterior fontanelle with intracranial extension is seen. The mass contains CSF with some linear structures representing most likely meninges with glial and neuronal rests. Persistent primitive falcine vein is seen which is vertically oriented to subcutaneous mass. High position of tentorium cerebelli with prominence of superior cerebellar cistern is also noted.
These findings are in keeping with atretic parietal cephalocele.
Atretic parietal cephalocele is a subgaleal lesion that consists of dura, fibrous tissue and dysplastic brain tissue.
Radiographic findings include:
- Subgaleal soft tissue mass with intracranial extension via 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 :
- 1.Osborn AG, Salzman KL, Barkovich AJ. Diagnostic Imaging: Brain. Lippincott Williams & Wilkins. (2009) ISBN:1931884722. Read it at Google Books - Find it at Amazon 2. Wong SL, Law HL, Tan S. Atretic cephalocele - an uncommon cause of cystic scalp mass. Malays J Med Sci. 2012;17 (3): 61-3. Free text at pubmed - Pubmed citation 3. Muralidharan CG, Aggarwal R, Singh D. Atretic parietal encephalocoele - An unusual diagnosis. Med J Armed Forces India. 2013;69 (1): 83-5. doi:10.1016/j.mjafi.2012.02.005 - Free text at pubmed - Pubmed citation