Lacunar Skull
Luckenschadel Skull

 


General Considerations

  • Bone dysplasia of skull consisting of multiple oval lucencies separated by dense, bony ridges
  • Associated with
    • Neural tube defects, especially myelomeningocele
    • Chiari II malformation
    • Encephalocele
  • Not related to degree of concomitant hydrocephalus
  • Inner table more affected than outer

Clinical Findings

  • Present at birth
  • Unrelated to increased intracranial pressure

Imaging Findings

  • Well-defined lucent areas in calvarium representing nonossified fibrous bone
  • Lacunae are bounded by normally ossified bone
  • Most prominent in parietal bones
  • Small posterior fossa associated with Chiari II malformation

Differential Diagnosis

  • Normal convolutional markings seen during a period of rapid brain growth (3 to 7 years).
  • Increased convolutional markings associated with synostosis at an older age
  • Increased intracranial pressure - beaten-silver appearance; closed sutures; may have abnormal skull size

Treatment

  • Appearance resolves spontaneously by age 6 months

Prognosis

  • Spontaneously disappears by 4-6 months old

 

 



Lacunar Skull. There are multiple focal areas of radiolucency in the skull (white arrows)
bounded by more normal, dense bony ridges.
The child had a known myelomeningocele.
For this same photo without the arrows, click here
For more information, click on the link if you see this icon

       

The Infant Skull: A Vault of Information.  RB J Glass, S K Fernbach, KI Norton, PS Choi and TP Naidich. March 2004 RadioGraphics, 24, 507-522.