Atretic parietal cephalocele

Case contributed by Dr Sepehr Haghighi

Presentation

A palpable scalp mass

Patient Data

Age: 2 years
Gender: Male
MRI

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.

Case Discussion

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 :

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Case information

rID: 65450
Published: 10th Jan 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Excluded from licensing
Institution: Children's medical center

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