title: Large parietal midline defect with unusual ridge-like structure at the rim and persistent falcine sinus.
abstract: BACKGROUND
  Midline cranial defects can be divided into lesions with intracranial tissue herniation (cranium bifidum cysticum) and lesions mainly with ossification failure (cranium bifidum occultum). Herniated cephaloceles mostly require surgical resection, while persisted parietal foramina might become smaller with age.
  
  
  METHODS
  Here, we report a neonate with large symmetric midline skull defect at high parietal area. A mild bulging mass was noticed. Interestingly, unlike sac herniation, it was surrounded by bony ridges extended from the rim of the calvarial defect, which suggests aberrant ossification. Persistent falcine sinus was also detected. At the corrected age of 11 months, the size of the skull defect had decreased spontaneously, favoring the diagnosis of parietal bone ossification defect. Potential mechanisms resulting in the special appearance of skull bone were discussed.
  
  
  CONCLUSIONS
  Incomplete closing of the parietal foramina might be expected due to the aberrant ridge formation. We suggest protective measures for the calvarial defect.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung San South Road, Taipei, Taiwan.
authors.forename: Chin-An
authors.initials: CA
authors.lastname: Yang
authors.affiliation: Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Steven Shinn-Forng
authors.initials: SS
authors.lastname: Peng
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung San South Road, Taipei, Taiwan.
authors.forename: Wu-Shiun
authors.initials: WS
authors.lastname: Hsieh
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung San South Road, Taipei, Taiwan.
authors.forename: Po-Nien
authors.initials: PN
authors.lastname: Tsao
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung San South Road, Taipei, Taiwan.
authors.forename: Chien-Yi
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 8, Chung San South Road, Taipei, Taiwan. hcchou@ntu.edu.tw.
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Chou
mesh_terms: D004677:Encephalocele / Q000175:diagnosis*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D008297:Male; D009999:Ossification, Heterotopic / Q000175:diagnosis*; D010294:Parietal Bone / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: Cranium bifidum; Falcine sinus; Skull defects
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