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The Skull – Supplement (Online Only)


THE CALVARIA

FIGURE 1S-1, The relative proportions of the cranial vault size to face size in the infant differ strikingly from those in the adult. Applying adult standards to the infant may suggest a disproportionate increase in vault size. At birth, the head-to-face ratio is approximately 4:1; in adulthood, this ratio is 3:2.

FIGURE 1S-2, Occipital skin folds.

FIGURE 1S-3, Striations over the parietal area caused by hair.

FIGURE 1S-4, Hair arrangements—in these two cases a ponytail may produce unusual shadows.

FIGURE 1S-5, Prominent venous vascular groove at the vertex of the skull.

FIGURE 1S-6, Vascular groove (sphenoparietal sinus) simulating fracture.

FIGURE 1S-7, Pacchionian depression with a central area of density. This appearance is often mistaken for a significant lesion such as an eosinophilic granuloma.

FIGURE 1S-8, Large pacchionian granulations of the vertex of the skull that lend an unusual configuration to the vertex.

FIGURE 1S-9, Huge anterior fontanel bone in a 1-year-old child.

FIGURE 1S-10, Wormian bones in a 9-year-old boy.

FIGURE 1S-11, Normal squamosal suture projected tangentially, simulating a fracture.

FIGURE 1S-12, Tangential projection of the squamosal suture producing a less obvious simulated fracture.

FIGURE 1S-13, Early sutural sclerosis in a 12-year-old boy.

FIGURE 1S-14, Localized thickening of the parietal bone, a normal variation.

FIGURE 1S-15, Parieto-occipital hyperostosis.

FIGURE 1S-16, Localized palpable thinning of the outer table of the skull in an asymptomatic 21-year-old woman. This probably represents an incomplete form of cranium bifidum occultum.

PHYSIOLOGIC INTRACRANIAL CALCIFICATIONS

FIGURE 1S-17, Petroclinoid calcification in the half-axial projection.

FIGURE 1S-18, Petroclinoid ligament with an unusual pattern of calcification.

FIGURE 1S-19, Unusual dural calcifications above anterior and posterior clinoid processes.

FIGURE 1S-20, The os supra petrosum of Meckel, seen on polytomography.

FIGURE 1S-21, Small localized focal dural calcification in the frontal area.

FIGURE 1S-22, Heavy calcification of the falx cerebri.

FIGURE 1S-23, Normal asymmetry of the calcified glomera of the choroid plexus. These cannot be reliably used for evidence of intracranial abnormality.

FIGURE 1S-24, Unilateral calcification of the glomus of the choroid plexus.

THE FRONTAL BONE

FIGURE 1S-25, Closing metopic suture mistaken for a fracture in a 1½-year-old boy. Closure occurs last in the cephalic end of the suture.

FIGURE 1S-26, Persistent metopic suture in a young adult. This suture may persist throughout life and may be mistaken for a fracture.

FIGURE 1S-27, Groove for the sagittal suture projected through the frontal bone, simulating a metopic suture.

FIGURE 1S-28, Unfused areas in the midline of the frontal bone (cranium bifidum occultum) in a 15-year-old child.

FIGURE 1S-29, Cranium bifidum occultum in a 14-month-old boy.

FIGURE 1S-30, Large external occipital protuberance projected through the frontal bone, simulating meningioma of the anterior fossa.

FIGURE 1S-31, Unusual scalloped appearance of the floor of the anterior fossa.

FIGURE 1S-32, Vascular channel simulating a skull fracture.

FIGURE 1S-33, Unilateral serpentine vascular channels in the frontal bone.

FIGURE 1S-34, Vascular groove simulating a fracture in a 1-year-old boy.

FIGURE 1S-35, Vascular channel of the frontal bone, unusually well seen in lateral projection.

FIGURE 1S-36, Focal thickening of the inner table of the frontal bone.

FIGURE 1S-37, Nebular hyperostosis frontalis interna.

FIGURE 1S-38, Asymmetric localized hyperostosis frontalis interna in a 20-year-old woman.

FIGURE 1S-39, Hyperostosis frontalis interna with a simulated sequestrum.

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