Foramina parietalia permagna: descrizione di un caso clinico e revisione della letteratura

The purpose of the present work is to expose the defects of parietal bone ossification and to identify the criteria for differential diagnosis and brain changes related to the condition, with particular attention to the venous developmental anomalies and the pathological features associated. Foramina parietalia permagna (FPP) are caused by an insufficient intramembranous ossification around the parietal notch that is normally obliterated in the fifth month of normal foetal development. During the first few years of life as calvarial growth continues, cranium bifidum tends to resolve into two distinct, large parietal foramina. Most people with FPP have a positive family history as the condition is inherited in an autosomal dominant fashion with high, but incomplete penetrance. Mutations of either MSX2 or ALX4 genes are associated with enlarged parietal foramina. Meningeal cortical vascular malformation of the straight sinus and persistent falcine sinus have also been reported in the literature as possible associated anomalies.

Parietal Cranium Bifidum: A Rare Presentation

ABSTRACT Aim To enlighten the readers regarding rare and distinct presentation of fetal encephalocele in parietal location and its significance. Background Cranium bifidum is a defect in the cranium through which there can be herniation of intracranial contents. If the content of herniation is meninges, it is called meningocele and if it contains brain tissue in addition to meninges, it is called meningoencephalocele or encephalocele. The incidence of encephalocele is 1 in 4,000 live births. The most common location is the occipital region (75%) followed by frontoethmoidal (15%), which is common in Asian population, and rarest is the basal followed by parietal locations. The exact incidence of parietal encephalocele is not available due to its rarity. Case report We present a case of a 24-year-old primigravida female in second trimester who came for antenatal scan to rule out anomalies. On examination by ultrasonography, we found a large cerebriform soft tissue herniating through a defect in skull vault from the vertex region with secondary microcephaly Conclusion Here we give an overview of rarest form of encephalocele in parietal region, which grossly differs from the already reported parietal encephaloceles of atretic type presenting as small skin-covered subscalp lesions that contain Meninges and neural and glial rests. In our case, the encephalocele was distinct, being larger in size with normal brain parenchyma as the major content of the herniating sac. Clinical significance Only few cases of parietal encephalocele is reported in the literature, that too of atretic type. Apart from being the rarest form, this variant is found to be associated with poor prognosis. How to cite this article Rathinam S, Rudrappa R, Talluri B. Parietal Cranium Bifidum: A Rare Presentation. Int J Infertil Fetal Med 2017;8(1):41-44.