Ultrasound diagnosis of luckenschadel (lacunar skull)

Abstract

Background. The neuroradiologic findings in the Chiari II malformation are well known. Luckenschadel (lacunar skull) is commonly seen in patients with Chiari II on plain film and with computed tomography (CT). However, the sonographic appearance of luckenschadel has not previously been described.¶Objective. To evaluate the presence or absence of luckenschadel on neurosonograms from infants with myelomeningocele.¶Materials and methods. Twenty-one neurosonograms in patients with myelomeningocele were reviewed for the presence of an irregular inner calvarial table indicative of luckenschadel. The degree of irregularity was graded and compared with CT and plain film when available. The ventricular index was calculated from the ultrasound (US) studies and correlated with degree of luckenschadel using one-way analysis of variance.¶Results. Nine patients had marked findings of luckenschadel, nine had mild findings, and three had normal US exams. There was no correlation between the degree of sonographic luckenschadel and the ventricular index.¶Conclusion. The finding of luckenschadel adds to the spectrum of abnormalities of the Chiari II malformation diagnosed by US.