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Kahl N, Lüsebrink N, Schubert-Bast S, Freiman TM, Kieslich M. Bilateral Foramina Parietalia Permagna - A Calvarial Defect Caused by Haploinsufficiency of the Msh Homeobox 2 Gene: A Case Report and Current Literature Review. Neuropediatrics 2024; 55:205-208. [PMID: 38447947 DOI: 10.1055/s-0044-1781465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Foramina parietalia permagna (FPP) is a rare anatomical defect that affects the parietal bones of the human skull. FPP is characterized by symmetric perforations on either side of the skull, which are caused by insufficient ossification during embryogenesis. These openings are typically abnormally large and can range from a few millimeters to several centimeters in diameter. Enlarged foramina are often discovered incidentally during anatomical or radiological examinations and in most cases left untreated unless symptoms develop. Although this calvarial defect is usually asymptomatic, it may be accompanied by neurological or vascular conditions that can have clinical significance in certain cases. FPP is an inherited disorder and arises due to mutations in either Msh homeobox 2 (MSX2) or aristaless-like homeobox 4 (ALX4) genes. In almost all cases, one parent is affected. Clinical findings and diagnostic imaging typically contribute to determine the diagnosis.
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Affiliation(s)
- Niklas Kahl
- Division of Neurology, Neurometabolics and Prevention, Department of Pediatrics, Goethe University Frankfurt, Frankfurt, Germany
| | - Natalia Lüsebrink
- Division of Neurology, Neurometabolics and Prevention, Department of Pediatrics, Goethe University Frankfurt, Frankfurt, Germany
| | - Susanne Schubert-Bast
- Division of Neurology, Neurometabolics and Prevention, Department of Pediatrics, Goethe University Frankfurt, Frankfurt, Germany
| | - Thomas M Freiman
- Department of Neurosurgery, Rostock University Medical Center, Rostock, Germany
| | - Matthias Kieslich
- Division of Neurology, Neurometabolics and Prevention, Department of Pediatrics, Goethe University Frankfurt, Frankfurt, Germany
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Al-Shuaili A, Al-Ajmi E, Mogali SR, Al-Qasmi S, Al-Mufargi Y, Kariyattil R, Sirasanagandla SR. Computed-tomography evaluation of parietal foramen topography in adults: a retrospective analysis. Surg Radiol Anat 2024; 46:263-270. [PMID: 38280004 DOI: 10.1007/s00276-023-03284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/13/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND The parietal foramen (PF) of the skull is a variable anatomic feature with important implications for venous drainage, infection, and injury. Its topography is clinically relevant for neurosurgeons for intracranial navigation and preoperative planning. METHODS PF topography was investigated in a series of 440 head computed-tomography scans of Omani subjects at Sultan Qaboos University Hospital. The mean age of the patients was 52 ± 17 years and there were 160 males and 280 females. The topography features of the PF, including frequency, diameter, patency, and relative position in relation to the superior sagittal sinus (SSS), were recorded. Additionally, sex and laterality differences in PF parameters were analyzed using a Chi-square test. RESULTS The overall prevalence of PF was 72.3% (318/440). The bilateral presence of PF was identified in 34% of skulls. Unilateral right-side prevalence was 18.2%, while left prevalence was 13.2% (p = 0.62). The prevalence of unilateral accessory PF on the right side was 1.8%, while it was 1.1% on the left (p = 0.69). PF within the sagittal suture/or intra-sutural PF was observed in 6.8% of skulls, with a frequency of 9.4% in men and 5.4% in women (p = 0.29). The diameter of the PF was 1.45 ± 0.74 mm on the right side, and 1.54 ± 0.99 mm on the left side (p = 0.96). There were 2% of incomplete PF. The PF was located over the SSS in 70.3% on the right side and 53.8% on the left side. No significant differences were observed between the PF topography parameters and sex or laterality. CONCLUSION The present study for the first time reports the baseline data of PF topography in a large sample of CT scans in the Arab population. The geography and race influence the PF topography differences. PF may be used as a reliable landmark of SSS. The morphological characteristics and distribution of PF reported in this study have clinical implications for imaging diagnosis, intracranial navigation of vascular disorders, and treatment.
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Affiliation(s)
- Anwar Al-Shuaili
- Radiology Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Eiman Al-Ajmi
- Department of Radiology and Molecular Imaging, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Sara Al-Qasmi
- College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Rajeev Kariyattil
- Department of Surgery, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Srinivasa Rao Sirasanagandla
- Department of Human and Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh 123, Muscat, Oman.
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Tan AP, Rasheed S, Sidpra J, Lim MC, James G, Oztekin O, Gonçalves FG, Mankad K. An algorithmic clinicoradiological approach to paediatric cranial vault lesions: distinguishing normal variants from pathologies. Br J Neurosurg 2023; 37:986-999. [PMID: 33960863 DOI: 10.1080/02688697.2021.1919599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
Lesions of the paediatric cranial vault are diverse both in their presentation and aetiology. As such, they pose a diagnostic challenge to the paediatric neurosurgeon and neuroradiologist. In this article, we delineate the spectrum of paediatric calvarial pathology into four distinct groups: (1) lytic lesion(s); (2) focal sclerotic lesion(s); (3) diffuse cranial vault sclerosis; and (4) abnormal shape of the cranial vault. It is our aim that this more pragmatic, algorithmic approach may mitigate diagnostic uncertainty and aid the more accurate diagnosis of paediatric calvarial lesions.
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Affiliation(s)
- Ai Peng Tan
- Department of Diagnostic Imaging, National University Health System, Singapore, Singapore
| | - Shabana Rasheed
- Department of Diagnostic Imaging, KK Children and Women's Hospital, Singapore, Singapore
| | - Jai Sidpra
- Developmental Biology and Cancer Section, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Mei Chin Lim
- Department of Diagnostic Imaging, National University Health System, Singapore, Singapore
| | - Greg James
- Department of Neurosurgery, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Ozgur Oztekin
- Department of Neuroradiology, Tepecik Education and Research Hospital, Izmir, Turkey
| | | | - Kshitij Mankad
- Department of Neuroradiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
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Abstract
A thorough understanding of the skull anatomy is of key importance to radiologists as well as specialist physicians and surgeons. We describe the anatomy of the neurocranium comprising calvaria (the skull vault) and the skull base and discuss the most common and clinically relevant anatomic variants.
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Affiliation(s)
- Tomasz Matys
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK; Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
| | - Daniel J Scoffings
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK. https://twitter.com/brainscandan
| | - Tarik F Massoud
- Division of Neuroimaging and Neurointervention, Department of Radiology, Stanford University School of Medicine, Stanford Health Centre, Palo Alto, CA, USA
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Shmarhalov A, Vovk O, Ikramov V, Acharya Y, Vovk O. ANATOMICAL VARIATIONS OF THE PARIETAL FORAMEN AND ITS RELATIONS TO THE CALVARIAL LANDMARKS: A CROSS-SECTIONAL CADAVERIC STUDY. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1648-1652. [PMID: 35962674 DOI: 10.36740/wlek202207106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim: Estimate the prevalence of the parietal foramen in the adult human skulls of Ukrainian origin, and study its morphology and relationships to main anatomical landmarks of the skull. PATIENTS AND METHODS Materials and methods: A cross-sectional observational study of PF was conducted with 42 random cadaveric adult human skull roofs (calvaria) collected from the laboratory and museum of Human Anatomy Department, Kharkiv National Medical University, Ukraine. The patency and the length of the PF canal were determined, and PF external/internal diameters and the distance to the calvarial landmarks from PF were measured using the caliper. Mean and standard deviation were calculated to compare with the existing data. RESULTS Results: In the present study 85.7% (n = 36) of the calvaria had the PF, 54.8% (n = 23) had bilateral location of PF, 30.9% (n = 13) had unilateral presence of PF (right side: 23.8%, n=10 and left side: 7.1%, n=3), and 14.3 % (n = 6) demonstrated bilateral absence of PF. CONCLUSION Conclusions: An anatomical variation in parietal foramen is not uncommon, and the differences can be based on multiple factors like geography and race. It is important to have detailed information on anatomical variations in different population groups to facilitate surgical and radiological interventions.
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Affiliation(s)
| | - Oleg Vovk
- KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE
| | | | - Yogesh Acharya
- GALWAY UNIVERSITY HOSPITAL, NATIONAL UNIVERSITY OF IRELAND, GALWAY, IRELAND
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MacDonald D, Patel A, Zou B, Yen E, Vora SR. A retrospective study of incidental findings occurring in a consecutive case series of lateral cephalograms of 12- to 20-year-old patients referred for routine orthodontic treatment. Imaging Sci Dent 2022; 52:295-302. [PMID: 36238700 PMCID: PMC9530292 DOI: 10.5624/isd.20220402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose Lateral cephalograms of orthodontic patients may contain incidental findings that could potentially lead to harm. Materials and Methods The lateral cephalograms of 1765 consecutive 12- to 20-year-old patients, being considered for routine orthodontic treatment, were retrospectively reviewed. These patients were considered normal, because no abnormalities were found either in their medical history or on their clinical examination. Results The overall prevalence of incidental findings was 18.8%, of which 10.3% were ponticulus posticus and 4.2% were bridging of the sella turcica. Although occipital spurs and ponticulus posticus were more prevalent in males, the size of the sella turcicas did not differ between sexes. Of the 1156 patients completing treatment about 2 years later, only one lateral cephalogram displayed progression of the ponticulus posticus in that time. Conclusion The prevalence of incidental findings on lateral cephalograms of otherwise normal orthodontic 12- to 20-year-old patients was almost a fifth, of which ponticulus posticus, vertebral fusion, and enlarged parietal foramina were clinically significant.
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Affiliation(s)
- David MacDonald
- Division of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Akash Patel
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bingshuang Zou
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edwin Yen
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Siddharth R. Vora
- Division of Orthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
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Baugher EC, Batarseh TR, Becker AK, Cantu AJ, Carr EW, Sakthi Velavan S. Multiple Osteochondromas Comorbid With Enlarged Parietal Foramina, Elongated Styloid Processes, and Tibiofibular Synostosis. Am J Clin Pathol 2021; 156:513-520. [PMID: 33769443 DOI: 10.1093/ajcp/aqaa282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study investigates a unique case of multiple osteochondromas (MO) comorbid with enlarged parietal foramina and correlates the findings with the existing literature. The aim of this study is to provide a deeper understanding of anatomic variation for physicians. METHODS A 66-year-old White male donor was examined during a routine cadaveric dissection performed by medical students in an anatomy laboratory. Detailed exploration of the skeleton and organs was performed, and photographs were taken. Tissue samples were obtained from multiple outgrowths, and histopathologic examination was done. RESULTS Bilateral bony growths were noted rising from the long bones of the upper and lower extremities (femur, tibia, fibula, and radius). An accessory muscle was found to be associated with the left radial bony growth. Histopathologic examination was positive for osteochondroma. Inspection of the skull revealed enlarged parietal foramina. Other findings included tibiofibular synostosis, abnormally shaped vertebral bodies and ribs, and elongated styloid processes of the skull. CONCLUSIONS In combination with the histopathologic examination, the case report and literature review elucidate a more precise clinical picture for those affected with MO or similar disorders. This report also emphasizes the necessity of further investigation of the pathogenesis of MO and Potocki-Shaffer syndrome.
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Affiliation(s)
- Elizabeth C Baugher
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
| | - Tamara R Batarseh
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
| | - Ashley K Becker
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
| | - Austin J Cantu
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
| | - Evan W Carr
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, IN, USA
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Bote Gascón M, Martínez del Río C, García Ron A. Foramina parietalia permagna: evaluación clínico radiológica de una familia española con mutación no descrita en el gen ALX4. An Pediatr (Barc) 2021. [DOI: 10.1016/j.anpedi.2020.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Bote Gascón M, Martínez Del Río C, García Ron A. Foramina parietalia permagna: Clinical radiological evaluation of a Spanish family with an undescribed mutation in the ALX4 gene. An Pediatr (Barc) 2021; 95:121-122. [PMID: 34315693 DOI: 10.1016/j.anpede.2020.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/31/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Marta Bote Gascón
- Servicio de Pediatría y sus Áreas Específicas, Unidad de Neuropediatría, Hospital Clínico San Carlos, Madrid, Spain.
| | - Carmen Martínez Del Río
- Servicio de Pediatría y sus Áreas Específicas, Unidad de Neuropediatría, Hospital Clínico San Carlos, Madrid, Spain
| | - Adrián García Ron
- Servicio de Pediatría y sus Áreas Específicas, Unidad de Neuropediatría, Hospital Clínico San Carlos, Madrid, Spain
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Ferreira Furtado LM, Da Costa Val Filho JA, Lima Vieira JA, Dantas Dos Santos AK. Trigonocephaly and Cranium Bifidum Occultum Treated Simultaneously Using the Split-Bone Technique and Piezosurgery. Cureus 2021; 13:e15346. [PMID: 34084690 PMCID: PMC8165942 DOI: 10.7759/cureus.15346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Cranium bifidum occultum (CBO) is a rare congenital disease characterized by the anomalous ossification of parietal bones, which presents with a midline bone defect with no extrusion of intracranial content. Its association with craniosynostosis has been reported only a few times to date. The aim of this case report was to describe, for the first time, the association between presumed non-syndromic trigonocephaly and CBO, as well as the treatment of both conditions using the same surgical approach. This was done by performing fronto-orbital advancement and the split-bone technique using piezosurgery, in order to achieve an autologous sample to cover the bone defect. To the best of our knowledge, this approach was proven to be safe and able to treat both diseases without a heterologous bone graft.
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Affiliation(s)
| | | | - José Antônio Lima Vieira
- Neurosurgery, Biocor Instituto, Nova Lima, BRA.,Pediatric Neurosurgery, Vila da Serra Hospital, Nova Lima, BRA
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11
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Lehmann L, Stefen C. Study of non-metric characters of the skull to determine the epigenetic variability in populations of the European wildcat (Felis silvestris silvestris) and domestic cats (Felis catus). Mamm Biol 2021. [DOI: 10.1007/s42991-021-00119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractWe studied the variability of non-metric cranial traits, mainly foramina, of European wildcats (Felis silvestris silvestris) and domestic cats (Felis catus) from Germany based on 28 non-metric traits in 211 skulls. The domestic cats were grouped together as a statistical population. The wildcats were divided into two populations: Harz and Hesse, which were further subdivided, based on traffic infrastructure, natural landscape, and in the Harz, on time period. Epigenetic variability, epigenetic distance and the fluctuating asymmetry were calculated to assess genetic variability, possible depressions and population stability. The epigenetic variability Iev of the wildcat groups ranged from 0.27 (Hesse II) to 0.40 (Harz I). The difference in Iev between all specimens from Harz and Hesse respectively was less (Iev = 0.37 Harz and 0.31 Hesse). Compared to other studies these values are not assumed to indicate genetic depression. The epigenetic distance between the wildcat samples is 0.0774 overall, and in each case higher between sub-groups of the Harz and Hesse than between groups within these regions, respectively. The significant epigenetic distance between Harz and Hesse might indicate—at least past formerly—restricted connectivity between these regions. The fluctuating asymmetry for wildcats in total is 11.74% and in the sub-groups it ranges from 8.47 to 16.14%. These values are below 20% are at the lower range known from populations of other mammal species. The use of fluctuating asymmetry had also been discussed critically in its usefulness to assess viability of populations.
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Walters ME, Lacassie Y, Azamian M, Franciskovich R, Zapata G, Hernandez PP, Liu P, Campbell IM, Bostwick BL, Lalani SR. Vertical transmission of a large calvarial ossification defect due to heterozygous variants of ALX4 and TWIST1. Am J Med Genet A 2020; 185:916-922. [PMID: 33369125 DOI: 10.1002/ajmg.a.62036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 11/08/2022]
Abstract
ALX4 is a homeobox gene expressed in the mesenchyme of developing bone and is known to play an important role in the regulation of osteogenesis. Enlarged parietal foramina (EPF) is a phenotype of delayed intramembranous ossification of calvarial bones due to variants of ALX4. The contrasting phenotype of premature ossification of sutures is observed with heterozygous loss-of-function variants of TWIST1, which is an important regulator of osteoblast differentiation. Here, we describe an individual with a large cranium defect, with dominant transmission from the mother, both carrying disease causing heterozygous variants in ALX4 and TWIST1. The distinct phenotype of absent superior and posterior calvarium in the child and his mother was in sharp contrast to the other affected maternal relatives with a recognizable ALX4-related EPF phenotype. This report demonstrates comorbid disorders of Saethre-Chotzen syndrome and EPF in a mother and her child, resulting in severe skull defects reminiscent of calvarial abnormalities observed with bilallelic ALX4 variants. To our knowledge this is the first instance of ALX4 and TWIST1 variants acting synergistically to cause a unique phenotype influencing skull ossification.
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Affiliation(s)
- Michelle E Walters
- Division of Dermatology, Harbor-UCLA Medical Center, Torrance, California, USA
| | - Yves Lacassie
- Division of Genetics, Department of Pediatrics, Louisiana State University Health Sciences Center School of Medicine, and Children's Hospital, New Orleans, Louisiana, USA
| | - Mahshid Azamian
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Rachel Franciskovich
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Gladys Zapata
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Patricia P Hernandez
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA
| | - Pengfei Liu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA
| | - Ian M Campbell
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Bret L Bostwick
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Seema R Lalani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Texas Children's Hospital, Houston, Texas, USA
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Abstract
Enlarged parietal foramina (PFM) are congenital calvarial defects characterized by bilateral parietal bone defects (>5 mm), occurring on each side of the sagittal suture along its posterior aspect. While often lacking underlying intracranial malformations, there has been increasing recognition of coexisting brain malformations in certain subtypes. We present a case of a 12-year-old girl presenting with new-onset grand mal seizure with developmental delay and a known family history of epilepsy. Brain MRI revealed large, bilateral parietal bone defects with underlying cortical malformation (polymicrogyria and ulegyria) and vascular abnormalities (persistent falcine sinus), related to PFM. This case report describes the genetic basis for recognized subtypes of PFM and the rare association of brain malformations associated with PFM due to mutations in the ALX4 homeobox gene.
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14
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Sasaki E, Byrne AT, Murray DJ, Reardon W. Caput membranaceum: A novel clinical presentation of ZIC1 related skull malformation and craniosynostosis. Am J Med Genet A 2020; 182:2994-2998. [PMID: 32975022 DOI: 10.1002/ajmg.a.61882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 11/11/2022]
Abstract
We report clinical and radiological features of a patient born with an isolated skull malformation of caput membranaceum and partial bicoronal craniosynostosis with a novel, de novo heterozygous missense variant in ZIC1 [NM_003412.3:c.1183C>G, p.(Pro395Ala)]. Caput membranaceum, or boneless skull, is a rare manifestation of skull ossification defect. It can result from an isolated, enlarged parietal foramina or it can present as part of skeletal dysplasia syndromes associated with poor mineralization such as hypophosphatasia, osteogenesis imperfecta type II, and Saethre-Chotzen syndrome. Their causative genes are well described. ZIC1, Zinc Finger protein of the cerebellum 1 (OMIM #600470) belongs to ZIC family genes, each encoding a Cys2 His2-type zinc finger domain-containing transcription factors. Recent studies have shown that pathogenic variants in ZIC1 have deleterious effect in developing human central nerves system and skull bone. ZIC1 related clinical conditions are reported and include cerebellum malformation, Dandy-Walker malformation, spinal dysraphism, microcephaly, and craniosynostosis with associated intellectual disability. To-date, there is no report of pathogenic variant in ZIC1 causing isolated caput membranaceum. Our observation adds to the clinical spectrum of ZIC1 related skull malformation.
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Affiliation(s)
- Erina Sasaki
- Clinical Genetics Department, Children's Health Ireland, Dublin, Ireland
| | - Angela T Byrne
- Department of Paediatric Radiology, Children's Health Ireland, Dublin, Ireland
| | - Dylan J Murray
- National Paediatric Craniofacial Centre (NPCC), Children's Health Ireland, Dublin, Ireland
| | - William Reardon
- Clinical Genetics Department, Children's Health Ireland, Dublin, Ireland
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Pons Escoda A, Naval Baudin P, Mora P, Cos M, Hernandez Gañan J, Narváez JA, Aguilera C, Majós C. Imaging of skull vault tumors in adults. Insights Imaging 2020; 11:23. [PMID: 32056014 PMCID: PMC7018895 DOI: 10.1186/s13244-019-0820-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022] Open
Abstract
The skull vault, formed by the flat bones of the skull, has a limited spectrum of disease that lies between the fields of neuro- and musculoskeletal radiology. Its unique abnormalities, as well as other ubiquitous ones, present particular features in this location. Moreover, some benign entities in this region may mimic malignancy if analyzed using classical bone-tumor criteria, and proper patient management requires being familiar with these presentations. This article is structured as a practical review offering a systematic diagnostic approach to focal calvarial lesions, broadly organized into four categories: (1) pseudolesions: arachnoid granulations, meningo-/encephaloceles, vascular canals, frontal hyperostosis, parietal thinning, parietal foramina, and sinus pericrani; (2) lytic: fibrous dysplasia, epidermal inclusion and dermoid cysts, eosinophilic granuloma, hemangioma, aneurysmal bone cyst, giant cell tumor, metastasis, and myeloma; (3) sclerotic: osteomas, osteosarcoma, and metastasis; (4) transdiploic: meningioma, hemangiopericytoma, lymphoma, and metastasis, along with other less common entities. Tips on the potential usefulness of functional imaging techniques such as MR dynamic susceptibility (T2*) perfusion, MR spectroscopy, diffusion-weighted imaging, and PET imaging are provided.
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Affiliation(s)
- Albert Pons Escoda
- Department of Neuroradiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain.
| | - Pablo Naval Baudin
- Department of Neuroradiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Paloma Mora
- Department of Neuroradiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Mònica Cos
- Department of Neuroradiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Javier Hernandez Gañan
- Department of Musculoskeletal Radiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - José A Narváez
- Department of Musculoskeletal Radiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Carles Aguilera
- Department of Neuroradiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Carles Majós
- Department of Neuroradiology, Hospital Universitari de Bellvitge, C. Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
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Fernandez J, Woodson S, Cannard K. Teaching NeuroImages: Enlarged parietal foramina inadvertently labeled as burr holes. Neurology 2019; 93:e827-e828. [PMID: 31427498 DOI: 10.1212/wnl.0000000000007978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Juan Fernandez
- From Walter Reed National Military Medical Center, Bethesda, MD.
| | - Sarah Woodson
- From Walter Reed National Military Medical Center, Bethesda, MD
| | - Kevin Cannard
- From Walter Reed National Military Medical Center, Bethesda, MD
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17
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Dossani RH, Yates DM, Kalakoti P, Nanda A, Notarianni C, Woerner J, Ghali GE. Cranium Bifidum Occultum Associated with Hypertelorism Treated with Posterior Vault Reconstruction and Orbital Box Osteotomies: Case Report and Technical Note. World Neurosurg 2017; 107:40-46. [PMID: 28522383 DOI: 10.1016/j.wneu.2017.05.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/01/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
Abstract
Cranium bifidum occultum is a disorder of skull ossification presenting as an enlarged posterior fontanelle in the upper posterior angle of the parietal bone near the intersection of the sagittal and lambdoid sutures. The standard treatment for cranium bifidum occultum is observation. We present a case of a 5-year-old boy who presented with a 15 × 4.5 cm midline posterior cranial vault defect consistent with diagnosis of cranium bifidum occultum associated with orbital hypertelorism and a widened nose. The patient underwent posterior vault reconstruction for correction of cranium bifidum occultum defect followed by bifrontal craniotomy and orbital box osteotomies for correction of orbital hypertelorism and nasal deformity. To our knowledge, this is the first reported case describing surgical treatment for cranium bifidum occultum associated with orbital hypertelorism.
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Affiliation(s)
- Rimal H Dossani
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - David M Yates
- Department of Oral and Maxillofacial/Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Piyush Kalakoti
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Anil Nanda
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
| | - Christina Notarianni
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Jennifer Woerner
- Department of Oral and Maxillofacial/Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Ghali E Ghali
- Department of Oral and Maxillofacial/Head and Neck Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA; Chancellor and Dean, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
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Murlimanju BV, Saralaya VV, Somesh MS, Prabhu LV, Krishnamurthy A, Chettiar GK, Pai MM. Morphology and topography of the parietal emissary foramina in South Indians: an anatomical study. Anat Cell Biol 2016; 48:292-8. [PMID: 26770881 PMCID: PMC4701704 DOI: 10.5115/acb.2015.48.4.292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 10/16/2015] [Accepted: 10/20/2015] [Indexed: 11/27/2022] Open
Abstract
The objectives of the present study were to study the prevalence of the parietal emissary vein in adult South Indian population and to study the distance of foramen from the sagittal suture. There were 58 adult human skulls in the present study which were available at the anatomy department of our institution. The study included 116 parietal bones which have been observed macroscopically for the number, prevalence and topography of the emissary foramen. The emissary foramen was present in 83 parietal bones (71.5%) of the present study. It was present at the junction between the middle 1/3 and posterior 1/3 region of the parietal bone. The foramen was observed solitary in 73 parietal bones (62.9%), double in 8 bones (6.9%), and triple in 2 parietal bones (1.7%). The foramen was not observed in 33 parietal bones (28.4%). The bilateral absence of parietal emissary foramen was seen in 7 skulls (12.1%). It was absent unilaterally in 19 skulls (32.7%). The accessory foramina were seen in only 8 skulls (13.8%). The mean distance of the foramen from the sagittal suture was 6.7±2.9 mm and 6.8±2.8 mm on the right and left sides respectively. The prevalence of parietal emissary vein in the present study was 71.5%. The present study has observed important data about the morphology and morphometry of the parietal emissary vein in South Indian population. The identification of parietal emissary veins and accessory veins is important in the operation room to prevent the blood loss.
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Affiliation(s)
- B V Murlimanju
- Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Vasudha V Saralaya
- Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - M S Somesh
- Department of Anatomy, Srinivas Institute of Medical Sciences & Research Centre, Srinivas University, Mangalore, Karnataka, India
| | - Latha V Prabhu
- Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Ashwin Krishnamurthy
- Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Ganesh Kumar Chettiar
- Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| | - Mangala M Pai
- Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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19
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Enlarged parietal foramina: a rare forensic autopsy finding. Int J Legal Med 2015; 130:855-7. [PMID: 26233611 DOI: 10.1007/s00414-015-1239-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
Abstract
Enlarged parietal foramina (EPF) are a quite rare developmental defect of the parietal bone which has to be distinguished from the normal small parietal foramina. We report a forensic case of an individual found in an advanced state of putrefaction in his own house with an undetermined cause of death. No evidence of trauma was observed, and the toxicological exam was negative. The victim was a 40-year-old man with a history of epilepsy. The large biparietal foramina, a rare anatomical variation and unusual autopsy finding, were observed at autopsy. The recognition of anatomical variations is important to avoid false interpretations and conclusions and has a significant potential as an identity factor, thus contributing to positive identification.
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Affiliation(s)
- Ruth-Mary deSouza
- Department of Neurosurgery, Kings College Hospital , Denmark Hill, London , UK
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21
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Piagkou M, Skotsimara G, Repousi E, Paraskevas G, Natsis K. Enlarged parietal foramina: a rare finding in a female Greek skull with unusual multiple Wormian bones and a rich parietal vascular network. Anat Sci Int 2013; 88:175-80. [PMID: 23543411 DOI: 10.1007/s12565-013-0173-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 03/01/2013] [Indexed: 11/29/2022]
Abstract
Enlarged parietal foramina (>5 mm) is an extremely rare developmental defect of the parietal bone, which is distinguished from the normal small parietal foramina, as genes associated with this entity have been identified, suggesting that it is hereditary in nature. We describe a dry skull of a 35-year-old female, with enlarged parietal foramina symmetrically situated bilaterally, oval in shape, measuring 4.5 × 9.3 mm (right) and 4.9 × 9.2 mm (left) in size. The foramina coexisted with multiple Wormian bones in several sites of the skull. On the inner parietal bone surface, the anterior, posterior and lateral foramina's rims carried grooves, which were continuous with the middle meningeal vessels' branches, indicating that a rich vascular network existed around the foramina. These vascular grooves also notched the external table at the margin of the foramina, which suggests a potential communication between the meningeal and the scalp vessels. In addition, this vascular variation should be taken into consideration when performing surgical interventions in the area, because the large vascular supply to the foramina is a possible source of extensive bleeding. Moreover, the interaction of intracranial and extracranial veins and the fact that the blood flows in them in both directions, as they are valveless, could represent a possible pathway for infections to spread in the cranial cavity.
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Affiliation(s)
- Maria Piagkou
- Department of Anatomy, School of Health, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527 Athens, Greece.
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