The infant skull: a vault of information.
The art of interpreting skull radiographs is slowly being lost as trainees in radiology see fewer plain radiographs and depend more heavily on computed tomography and magnetic resonance imaging. Nevertheless, skull radiographs still provide significant information that is helpful in finding pathologic conditions and appreciating their extents. Abnormalities in the skull may be reflected as variations in the density, size, and shape of the skull, as well as skull defects. Skeletal dysplasias may manifest as a generalized decrease in calvarial density (hypophosphatasia, osteogenesis imperfecta), a generalized increase in calvarial density (osteopetrosis), or a focal increase in density (frontometaphyseal dysplasia). Diffusely decreased or increased calvarial density is usually associated with a process that affects the entire skeleton. Therefore, correct differentiation among these dysplasias depends on other concurrent features. Decreased size of the cranial vault at birth generally implies an underlying insult to the brain, including fetal alcohol syndrome and the so-called TORCH infections (toxoplasmosis, rubella, cytomegalovirus infection, herpes simplex). Macrocephaly may result from skeletal dysplasia or an increase in the intracranial volume (eg, due to underlying anomalies of the brain such as hydrocephalus).
Glass
Ronald B J
RB
Department of Radiology, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA. ronald.glass@mountsinai.org
Fernbach
Sandra K
SK
Norton
Karen I
KI
Choi
Paul S
PS
Naidich
Thomas P
TP
D015519:Bone Density; D001847:Bone Diseases / Q000000981:diagnostic imaging*; D001848:Bone Diseases, Developmental / Q000000981:diagnostic imaging; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D001859:Bone Neoplasms / Q000000981:diagnostic imaging; D019465:Craniofacial Abnormalities / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007938:Leukemia / Q000000981:diagnostic imaging; D017254:Leukemic Infiltration / Q000000981:diagnostic imaging; D008297:Male; D008831:Microcephaly / Q000000981:diagnostic imaging; D011859:Radiography; D012886:Skull / Q000002:abnormalities / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000196:embryology; D012887:Skull Fractures / Q000000981:diagnostic imaging