It is important to mention that preoperative planning using CT scan is necessary to confirm the thickness of parietal bone
and to identify anatomical variations that could putting at risk surgery.
Nuchal view of skull showing occipital condyle (a); foramen magnum (b); paracondylar process (c); sagittal crest (d); petrous part of temporal bone (e); dorso-condylar fossa (f); squamous part of occipital bone (g); nuchal crest (h); occipital bone (i); parietal bone
Fig 3 shows that the sphenoparietal type is a sutural pattern in which the sphenoid and parietal bones
are in direct contact, preventing the frontal and temporal bones making contact with one another.
The lambdoid suture between the parietal and occipital squamous bones was invaginated more in the middle towards the parietal bone
and the coronal suture was straight.
b) Cranial width (Wcr): Maximum distance between the highest points of the parietal bone
Physical and radiological findings Findings n % Skull fractures Linear fractures 25 73.5 Occipital bone 7 28.0 Temporal bone 6 24.0 Frontal bone 9 36.0 Parietal bone
3 12.0 Depressed fractures 18 52.9 Frontal bone 8 44.4 Parietal bone
4 22.2 Occipital bone 6 33.3 Basis Cranii Fractures 17 50.0 Frontobasal 7 41.2 Temporobasal 6 35.3 Occipitobasal 4 23.5 Intracranial lesion Extradural hematoma 13 38.2 Subarachnoid hemorrhage 6 17.6 Subdural hematoma 4 11.8 Cerebral edema 8 23.5 Diffuse axonal injury 2 5.9 Pneumocephalus 13 38.2 Additional lesions Subgaleal hematoma 14 41.2 Unilateral/bilateral periorbital hematoma 7 20.6 Otorrhea 3 8.8 Otorrhagia 1 2.9 Rhinorrhea 1 2.9 Rhinorrhagia 4 11.8 Superficial scalp maceration 9 26.5 Figure 1.
CT images (C), show well circumscribed densely calcified dural-based lesion associated with buckling of adjacent cerebral cortex, irregularity along the adjacent inner table of right parietal bone
and reactive hyperostosis.
However, skull X-ray series showed mass like lesion with sclerotic rim in the left parietal bone
area (Figure 1).
The largest lesion, in the left parietal bone
, measured 3 cm in its greatest diameter, whiletheremainderofthe lesions measuredless than 1 cm.
* Fractures A, B, and C are linear fractures on the endocranial surface of the right parietal bone
measuring approximately 6 cm, 4 cm, and 4 cm long, respectively (Figure 2).
We added some parts of the parietal bone
to the frontal bone segment (Figures 1 and 2).
The image ranges of each class were defined as follows: brain, slice from the anterior tip of the parietal bone
to the foramen magnum; neck, slice from the foramen magnum to the pulmonary apex; chest, slice from the pulmonary apex to the diaphragm; abdomen, slice from the diaphragm to the top of an iliac crest; and pelvis, slice from the top of an iliac crest to the distal end of the ischium.
It appeared that the infant had suffered bilateral parietal bone
fractures and fractures of the ribs.
An urgent noncontrast computed tomography (CT) of the brain excluded acute vascular or posttraumatic lesions but showed an area of bone rarefaction localized in the parasagittal left parietal bone
, associated with an ipsilateral parietal encephaloclastic cortical and subcortical brain lesion (Figure 1).