Skull Development and Abnormalities

  • Robert A. Zimmerman


Prior to computed tomography (CT), plain skull radiographs were often the first study in the patient with suspected central nervous system disease [1]. Subtle clues to the intracranial contents could be discerned by the presence of calcification, skull erosion, and signs of increased intracranial pressure, as with demineralization of the sellae or an increase in the size of mastoid emissary veins, as well as by recognition of diseases primarily affecting the osseous structure of the skull in the form of sclerotic and/or lytic lesions (Fig. 29.1). CT revolutionized the radiologist’s ability to see the intrinsic structure of the skull in cross-section. This has decreased the demand for skull x-rays. Magnetic resonance imaging (MRI) has further decreased the demands for skull films, by showing the intracranial contents even more exquisitely than CT. Today, the skull radiograph plays a relatively limited role in the evaluation of the pediatric patient. Except in the evaluation of trauma, craniosynostosis, and known genetic diseases affecting the cranial structures, the skull x-ray tends to be a procedure that follows the recognition of its need on the basis of another examination, such as CT, MRI, or the radionuclide study.


Osteogenesis Imperfecta Occipital Bone Eosinophilic Granuloma Basilar Invagination Outer Table 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Shapiro R, Robinson F. The embryogenesis of the human skull: an anatomic and radiographic atlas. Cambridge, MA: Harvard University Press, 1980.Google Scholar
  2. 2.
    Madeline LA, Elster AD. Suture closure in the human chondrocranium: CT assessment. Radiology 1995; 196:747–756.PubMedGoogle Scholar
  3. 3.
    Fernbach SK, Naidich TP. Radiological evaluation of craniosynostosis. In: Cohen MM Jr, ed. Craniosynostosis: Diagnosis, Evaluation and Management. New York: Raven Press, 1986:191–214.Google Scholar
  4. 4.
    Zimmerman RA, Bilaniuk LT. Age related incidence of pineal calcification detected by CT. Radiology 1982; 142:659–662.PubMedGoogle Scholar
  5. 5.
    Jarvis JL, Keats TE. Cleidocranial dysostosis. AJNR Am J Neuroradiol 1974; 121:5–16.Google Scholar
  6. 6.
    Pozo JL, Crockar HA, Ransford AO. Basilar impression in osteogenesis imperfecta. J Bone Joint Surg [Br] 1984; 66:233.Google Scholar
  7. 7.
    Bartynski WS, Barnes PD, Wallman JK. Cranial CT of autosomal recessive osteoporosis. AJNR Am J Neuroradiol 1989; 10:543–550.PubMedGoogle Scholar
  8. 8.
    Sulik KK, Johnston MC, Smiley SJ, Speight HS, Jarvis BE. Mandibulofacial dysostosis (Treacher Collins syndrome): a new proposal for its pathogenesis. Am J Med Genet 1987; 27:359–372.CrossRefPubMedGoogle Scholar
  9. 9.
    Shiang R, Thompson LM, Zhu YZ, Church DM, Fielder TJ, Bocian M, Winokur ST, Wasmuth JJ. Mutations in the transmembrane domain of FGFR3 cause the most common genetic form of dwarfism, achondroplasia. Cell 1994; 78:335–342.CrossRefPubMedGoogle Scholar
  10. 10.
    Rousseau F, Bonaventure J, Legeai-Mallet L, Pelet A, Rozet JM, Maroteaux P, Le Merrer M, Munnich A. Mutations in the gene encoding fibroblast growth factor receptor-3 in achondroplasia. Nature 1994; 371:252–254.CrossRefPubMedGoogle Scholar
  11. 11.
    Hecht JT, Nelson FW, Butler IJ, Horton WA, Scott CI Jr, Wassman ER, Mehringer CM, Rimoin DL, Pauli RM. Computed tomography of the foramen magnum: Achondroplastic values compared to normal standards. Am J Med Genet 1985; 20:355–360.CrossRefPubMedGoogle Scholar
  12. 12.
    Watts RW, Spellacy E, Kendall BE, du Boulay G, Gibbs DA. Computed tomography studies on patients with mucopolysaccharidoses. Neuroradiology 1981; 21:9–23.CrossRefPubMedGoogle Scholar
  13. 13.
    Thomas SL, Childress MH, Quinton B. Hypoplasia of the odontoid with atlanto-axial subluxation in Hurler’s syndrome. Pediatr Radiology 1985; 15:353–354.CrossRefGoogle Scholar
  14. 14.
    Lipson SJ. Dysplasia of the odontoid process in Morquio’s syndrome causing quadriparesis. J Bone Joint Surg 1977; 59A:340–344.Google Scholar
  15. 15.
    Sze G, Uichanco LS III, Brant-Zawadzki MN, Davis RL, Gutin PH, Wilson CB, Norman D, Newton TH. Chordomas: MR imaging. Radiology 1988; 166:187–191.PubMedGoogle Scholar
  16. 16.
    Lee YY, Van Tassel P. Craniofacial chondrosarcomas: imaging findings in 15 untreated cases. AJNR Am J Neuroradiol 1989; 10:165–170.PubMedGoogle Scholar
  17. 17.
    Meyer J, Oot R, Lindfors K. CT appearance of clival chordomas. J Comp Assist Tomogr 1986; 10:34–38.CrossRefGoogle Scholar
  18. 18.
    Kornreich L, Grunebaum M, Ziv N, Cohen Y. Osteogenic sarcoma of the calvarium in children: CT manifestations. Neuroradiology 1988; 30:439–441.CrossRefPubMedGoogle Scholar
  19. 19.
    Friend SH, Bernards R, Rogelj S, Weinberg RA, Rapaport JM, Albert DM, Dryja TP. A human DNA segment with properties of the gene that predisposes to retinoblastoma and osteosarcoma. Nature 1986; 232:643–646.CrossRefGoogle Scholar
  20. 20.
    Tefft M, Fernandez C, Donaldson M, Newton W, Moon TE. Incidence of meningeal involvement by rhabdomyosarcoma of the head and neck in children: a report of the Intergroup Rhabdomyosarcoma Study (IRS). Cancer 1978; 42:253–258.CrossRefPubMedGoogle Scholar
  21. 21.
    Rawlings CE, Wilkins RH. Solitary eosinophilic granuloma of the skull. Neurosurgery 1984; 15:155–161.CrossRefPubMedGoogle Scholar
  22. 22.
    Moore JB, Kulkarni R, Crutcher DC, Bhimani S. MRI in multifocal eosinophilic granuloma: staging disease and monitoring response to therapy. Am J Pediatr Hematol Oncol 1989; 11:174–177.PubMedGoogle Scholar
  23. 23.
    Lee YY, Van Tassell P, Raymond AK. Intracranial dural chondrosarcoma. AJNR Am J Neuroradiol 1988; 9:1189–1193.PubMedGoogle Scholar
  24. 24.
    Oot RF, Melville GE, New PF, Austin-Seymour M, Munzenrider J, Pile-Spellman J, Spagnoli M, Shoukimas GM, Momose KJ, Carroll R, et al. The role of MR and CT in evaluating clival chordomas and chondrosarcomas. AJR Am J Roentgenol 1988; 151:567–575.PubMedGoogle Scholar
  25. 25.
    Greenberg HS, Deck MD, Vikram B, Chu FC, Posner JB. Metastasis to the base of the skull: Clinical findings in 43 patients. Neurology 1981; 31:530–537.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2005

Authors and Affiliations

  • Robert A. Zimmerman
    • 1
  1. 1.Neuroradiology Division/MRIChildren’s Hospital of PhiladelphiaPhiladelphiaUSA

Personalised recommendations