November 26, 2008

A child with scalp mass

Sagittal T1W image demonstrates a parieto-occipital scalp mass with a band of soft tissue anterosuperior to the mass running through a small skull defect which appears to connect to the intracranial compartment.


Sagittal T2W image demonstrates a persistent embryonic falcine sinus/vertically oriented straight sinus and prominence of the superior cerebellar cistern.



The mass shows a thin peripheral enhancement as well as enhancement of the soft tissue band.


Diagnosis:
Atretic (en)cephalocele
Facts:
- A midline mass typically parietal in location, occasionally seen in occipital region.
- Contain meninges and neural rests. A fibrous stalk connects the lesion to the dura.
- A vertically positioned straight sinus/persistent embryonic falcine sinus commonly
associated with these malformations. Anomalies of the tentorial incisura and superior sagittal
sinus have also been reported.
- Associated intracranial anomalies are variable, and some children may have normal clinical outcomes with no associated intracranial anomalies

References:
AJNR Am J Neuroradiol 19:791–795, April 1998
RadioGraphics 2004; 24:1655–1674

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