Cloverleaf shaped skull in the absence of craniosynostosis

Case contributed by Dr Saeed Soltany Hosn

Presentation

A 7-day-old male infant from a second full-term uncomplicated pregnancy brought to the children's hospital. His mother and father were normal and unrelated, 27 and 32 years olds, respectively. On examination, he had syndactyly, frontal bossing and depressed nasal bridge. CT brain was performed for further evaluation.

Patient Data

Age: 7-day
Gender: Male

Frontal and bitemporal bulging of the calvarium with depressed nasal bridge. Hydrocephalus also is noted.

Frontal bossing and depressed nasal bridge. Syndactyly of several digits.

Case Discussion

A cloverleaf deformity of the skull consists of trilobed protrusion of the skull with broadening of the frontal and bitemporal region. It typically results from intrauterine premature closure of sagittal, coronal and lambdoid sutures, although other combinations of sutural involvement are possible.

Rarely, a cloverleaf shaped skull may occur in the absence of craniosynostosis. In this condition there was hypoplasia of several cranial bones, allowing eventration of the brain and surrounding tissues into a trilobed configuration.

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