Lacunar skull

Case contributed by Robert Foley

Presentation

Term baby, delivered by forceps this morning. Swelling and bruising noted over right parietal area. Some crepitus felt. Neurology normal. Skull fracture?

Patient Data

Age: 3 days
Gender: Male

Initial radiograph

X-ray

The skull vault is mildly deminseralised with rounded areas of decreased lucency, particularly evident in the parietal and occipital bones.

CT

The frontal, parietal and occipital bones are markedly thinned, with large foramina where there is no mineralization at all.

Follow up radiograph 4 months later

X-ray

The previously demonstrated areas of lucency in the skull vault have resolved. 

Case Discussion

These radiographs demonstrate the classical appearance of lacunar skull. These changes usually resolve by 6 months of age 1

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