FRONTAL FORAMINA IN PEDIATRIC SKULL IN CASES CONGENITAL HYDROCEPHALUS

PURPOSE: To describe a new observation, frontal calvarial foramina, in pediatric patients with congenital hydrocephalus secondary to central nervous system malformation. MATERIALS AND METHODS: Frontal foramina were initially identified in three female patients with Chiari II malf ormation. Subsequently, head computed tomographic (CT) scans in 99 pat ients with congenital hydrocephalus were retrospectively reviewed. CT scans in a control group of 116 patients without hydrocephalus were al so retrospectively reviewed. RESULTS: Frontal foramina were found in e ight of 61 (13%) patients with Chiari II malformation, in one child wi th Dandy-Walker malformation, and in one child with occipital horn dil atation (colpocephaly), but not in control patients. Sequential CT exa minations in three patients with frontal foramina depicted gradual clo sure after ventriculoperitoneal shunt placement CONCLUSION: Frontal fo ramina may represent an abnormality variably expressed in certain cent ral nervous system malformations that cause congenital hydrocephalus. The presence of frontal foramina palpated or visualized on plain radio graphs may help in the diagnosis of congenital hydrocephalus and centr al nervous system malformation.