A FEMALE INFANT, the product of a normal pregnancy and delivery, presented with an 8× 8-cm soft scalp mass in the right parietal region. The mass grew larger when the right jugular vein was compressed or when she cried. The appearance resembled fluctuant, bulging veins that were easily compressed (Figure 1 ), and the lesion was covered by red and ulcerated skin, with associated areas of alopecia. Under the veins, osseous grooves were palpable. No thrill or bruit was present. Results of the physical and neurological examination and routine laboratory studies were otherwise normal. Skull roentgenograms, a cranial computed tomographic scan (Figure 2), and a selective internal angiogram of the carotid sinus (Figure 3) were obtained.
Denouement and Discussion
Sinus pericranii is an abnormal communication between the extracranial and intracranial venous systems, usually involving the superior sagittal or transverse sinus. In this malformation, a network of thin-walled veins adhere
Bonioli E, Bellini C, Palmieri A, Fondelli MP, Donati PT. Case 2. Arch Pediatr Adolesc Med. 1994;148(6):607-608. doi:10.1001/archpedi.1994.02170060061010