Calvarial thickening from chronic shunting

Case contributed by Maxime St-Amant
Diagnosis almost certain

CT scan scouts demonstrate moderate homogeneous thickening of the cranial vault, two ventriculoperitoneal shunts in-situ, and marked pneumatization of the frontal sinuses.

  • moderate thickening of the cranial vault is noted with two ventriculoperitoneal shunts in-situ
  • ex-vacuo dilatation of the left occipital horn secondary to left occipital encephalomalacia
  • dysgenesis of the corpus callosum - the genu and anterior part of the body are present, but very thin; the remainder of the corpus callosum is not seen
  • cerebellar tonsillar ectopia
  • low-lying torcula
  • possible basilar kyphosis (not actually measured, but angle seems exagerrated
  • marked pneumatization of the frontal sinuses, suggesting pneumosinus dilatans
  • mucosal thickening within the ethmoid sinuses
  • marked pneumatization of the mastoids

Case Discussion

It is not known whether this patient had Chiari II malformation or not, but the constellation of intracranial findings suggest that this is a possibility.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.