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Neutrophilic dermatoses include a heterogeneous group of entities. Uncommonly, they can accumulate aseptic neutrophilic abscesses in other tissues in addition to the skin. A 34-year-old female complained of a headache which was unresponsive to usual drugs. A TAC revealed an osteolytic lesion in the right parietal bone. The biopsy showed osteomyelitis. One year later, pyoderma gangrenosum appeared in the anterior aspect of both legs. The headache and the cutaneous lesions disappeared after treatment with oral prednisone. The bone involvement in the background of neutrophilic dermatoses is exceptional. Usually, it involves children in the context of chronic recurrent multiple osteomyelitis (CRMO). Only two cases have been described in adults. One of them was a 26-year-old woman who had had CRMO since childhood, and the other one in contiguity with the cutaneous lesions of pyoderma gangrenosum.

Objective: To reconstruct the etiology of a perimortem injury observed on a Neolithic – Chalcolithic cranium (5060 – 4400 yrs cal. BP). Materials: A cranium of an old adult male individual belonging to a collective burial from Cova Foradada site (Calafell, Tarragona, Spain). Methods: The cranium was analyzed macroscopically and microscopically using micro-CT scan. Results: The fracture on the right parietal bone presents characteristics of perimortem trauma. The morphology of the point of impact allows for the interpretation of this fracture as a result of impact by an object with a straight and sharp edge. In addition, the same cranium presents two healed antemortem injuries. Conclusions: The object that most likely caused the cranial fracture was a stone adze. The blow occurred from behind the individual, possibly by a right-handed attacker. Significance: The potential to link cranial fractures with specific tools increases our understanding of interpersonal violence during the Neolithic. Limitations: It is not possible to infer if this cranial injury was related to a large-scale intergroup confrontation or an intragroup violent event. Suggestions for further research: To investigate additional similar sites in the northeastern Iberian Peninsula to better characterize the fracture pattern caused by stone axes and adzes as well as other objects used as weapons during the Neolithic – Chalcolithic ages., This work was supported by the Ministerio de Ciencia, Innovación y Universidades (FPU18-02291 scholar-ship); Ministerio de Ciencia, Innovación y Universidades/Fondo Europeo de Desarrollo Regional [PGC2018-093925-B-C32]; Agència de Gestió d’Ajuts Universitaris i de Recerca [SGR 2017-1040]; Departament de Cultura de la Generalitat de Catalunya [CLT009-18-00024]; and Universitat Rovira i Virgili, projects [2014, 2015 and 2016 PFR-URV-B2- 17] and [2018 PFR-URV-B2-91], framed in the Programa de Centros de Recerca de Catalunya (CERCA), Generalitat de Catalunya.

An 8-month-old girl presented with a right raccoon eye and right Battle’s sign ([figure 1A,B][1]), which are signs of a basal skull fracture,[1][2] after a fall from a height of 40 cm the previous day. A head thin-slice CT scan revealed a right parietal bone simple fracture ([figure 1C,D][1])

This study uses multiple scientific methods to analyse a case of trepanation from a cemetery located at the westernmost point along the ancient Silk Road in China dating back to the Early Iron Age. The skull of interest belonged to a middle-aged male; the opening is located on the left posterior side of the skull in the occipital bone. Computer tomography (CT) and microscopic observation show that the incision was unhealed, indicating an immediate death either during or after the operation. The procedure of trepanation might have been used to treat a depressed fracture from inflicted trauma on the individual’s right parietal bone, suggesting the presence of surgical trepanation in early Western China.

We report the case of a 40-year-old man presenting with focal headache and a bulge at the right parietal bone, diagnosed as an intradiploic arachnoid cyst. The cyst wall included “meningothelial hyperplasia,” which is a rare finding. While over 40 cases of intradiploic arachnoid cysts have been reported to date, meningothelial hyperplasia in an intradiploic arachnoid cyst does not appear to have been reported. We also discuss the pathological findings of arachnoid cysts with meningothelial hyperplasia and mechanisms of enlargement of the arachnoid cyst.

A 69-year-old man presented for focal seizures characterized by dysarthria, confusion, left hand paresthesia, and hemifacial contractions. He had a 3-year history of episodes of epigastric burning, followed by confusion, olfactory hallucinations, and deja vu. Head CT scan showed a lytic lesion of right parietal bone (figure 1A). MRI highlighted transcalvarial herniation of precuneus gyrus (figure 1B), suggesting a congenital or posttraumatic skull defect or an osteolytic lesion. After surgical repair and excision of adjacent injured brain tissue, histopathology revealed osteolytic meningioma (figure 2). Intraosseous meningioma is extremely rare, may cause transcalvarial herniation by osteolysis,1 and can be revealed by histopathology.

The dolmen of Carrascal (Sintra, Portugal) was discovered at the end of the 19th century. The human bones housed in the Museu dos Serviços Geológicos (Lisbon) were re-analysed in the scope of a research program that is investigating the past lifeways of Late Neolithic populations from the central and southern regions of Portugal. Recent fieldwork under the scope of the Recovery and Valorisation project of the monument undertaken by the Sintra Municipality allowed constructional aspects of the tomb to be clarified, and the recovery of further osteological and archaeological remains. The radiocarbon dates obtained from the human bones enable us to assign this monument to an initial phase of the funerary practices associated with megalithic monumentality in Western Iberia. The assemblage comprised a minimum of 9 adults (both sexes) and 5 non-adults. Evidence of infectious disease, degenerative and metabolic changes, and a remodelled trepanation performed on a right parietal bone were noted. The dental remains yielded particularly interesting information regarding non-masticatory use of teeth, in form of chips and notches in anterior teeth. The data were compared with other collections exhumed from coeval tombs to obtain insights into the health status and behaviours of these prehistoric populations., El dolmen de Carrascal (Sintra, Portugal) fue descubierto a finales del siglo XIX. Los restos óseos humanos depositados en el Museu dos Serviços Geológicos (Lisboa) han sido re-analizados con un programa que investiga el estilo de vida de las poblaciones del Neolítico Final de las regiones del centro/sur de Portugal.Según los recientes trabajos de campo enmarcados en el proyecto de Recuperación y Valorización del monumento llevados a cabo por el Municipio de Sintra, estos han permitido clarificar aspectos de la construcción y la recuperación del material osteológico y arqueológico.Los datos de radiocarbono de los restos óseos humanos nos permiten encuadrar las prácticas funerarias en una fase inicial del megalitismo en el oeste de la península ibérica. La colección comprende un mínimo de 9 adultos (ambos sexos) y 5 no adultos.Se han observado evidencias de enfermedades infecciosas, cambios degenerativos, alteraciones metabólicas y una trepanación remodelada realizada en un parietal derecho.Los restos dentales ofrecen información particularmente interesante con respecto a otros usos no masticatorios de los dientes. Esto se manifiesta en forma de astillas y agujeros en los dientes anteriores.Estos datos han sido comparados con otras colecciones contemporáneas de Portugal con el objetivo de observar la salud y el comportamiento de estas poblaciones prehistóricas.

Summary Two foals were admitted for neurological signs after trauma. Clinical and diagnostic investigations were performed that were suggestive of closed head trauma characterised by right parietal bone deviation (ping-pong fracture), cerebral contusion, haematoma and cerebellar contusion. The histopathological findings were consistent with areas of abnormal signal found on magnetic resonance investigations.

Penetrating cranial injury is a potentially life-threatening condition. Shell and shrapnel fragments are the most common cause of high velocity penetrating head injuries. The pathophysiological consequences of penetrating head injuries depend on the kinetic energy and trajectory of the object. If the velocity of the penetrating object is high enough, the object shape and sharpness is not very important for penetrance. We reported a case of transcranial injury caused by a broken wooden shovel handle. The Glasgow Coma Scale score of the patient was 4 in the emergency department. Wooden shovel handle had entered through the right maxillary region, penetrated the brain and come out of the skull through the right parietal bone. Surgery was planned according to the radiological studies. Expeditious removal of the foreign body was carried out by craniotomy. The patient died on postoperative day 3. A number of high velocity transcranial injuries have been reported in the literature, but to the best of our knowledge, there was no report on transcranial injury with a wooden shovel handle.

A human skeleton of phenomenal size was uncovered during the excavation of a prehistoric site located in the city of Shangnan, Shaanxi province, China, in 2006. The skeleton dates to 4240–4100 cal yr BP, corresponding to the Longshan culture (4400–4000 yr ago). The skeletal characteristics point to a young male 16–18 yr old with a height of 193 cm. This is the tallest skeleton ever discovered in prehistoric China, and thus we name him the “Longshan Giant.” The giant appears to be of the Mongoloid race and has many physical characteristics that are similar to those of modern southern Asians. Upon closer examination, 3 drilled holes of 5 cm in diameter were found in the right parietal bone of the skull. No rationale exists yet to explain the presence of these holes.

Aneurysmal bone cysts are locally destructive, vascular, multicystic benign tumors of bone, which are usually located on metaphysis. Cranial aneurysmal bone cysts are uncommon. We report a 18-year-old girl with a 3-month history of skull asymetry and headache which was not relieved by analgesic drugs. Computed tomography scan demonstrated an osteolytic skull lesion of the right parietal bone and the neural tissue that was compressed without midline shift. The patient had complete recovery after total excision of the lesion. We also discuss the etiology, pathogenesis, pathologic features, imaging characteristics and treatment of cranial aneurysmal bone cysts.

A nontraumatic spontaneous extradural hematoma, in a fully conscious 10-year-old male child, caused by a solitary eosinophilic granuloma of calvarium presented as a case of localized painful swelling of the head, which rapidly expanded and decreased in size. A plain CT-scan of the head with bone window revealed eroded right parietal bone with subperiosteal debris and extradural hematoma of mixed density. Immediate evacuation of the extradural clot and complete excision of the lesion was performed to prevent the deterioration of the patient and to achieve the histological diagnosis for further management.

Maternal History ### Presentation The infant was born by cesarean section after several attempts at vaginal delivery with forceps assistance. The pediatrics team was present at the delivery. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. Initial physical examination revealed a depressed region over the right parietal bone. The infant was brought to the neonatal intensive care unit for further evaluation and management. ### Vital Signs ### Physical Examination

Forensic and archaeological examinations of human skeletons can provide us with evidence of violence. In this paper, we present the patterns of two cranial lesions found on an adult male (T173) buried in a grave in the necropolis ‘Isolato 96’, Messina, Sicily, dating back to the Roman Empire (1st century BC - 1st century AD). The skull reveals two perimortem traumatic lesions, one produced by a sharp object on the right parietal bone and the other one on the left parietal bone, presumably the result of a fall. The interpretation of fracture patterns found in this cranium are an illustration of how forensic approaches can be applied with great benefit to archaeological specimens. 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Ossified cephalhematoma is a rare clinical entity. Even though cephalhematoma is frequently encountered, ossified cephalhematoma occurs only sporadically. We report a 13-week-old boy who was admitted to neurosurgery clinic with deformity of the skull. A plain skull radiograph showed radiolucent areas in the right parietal region. CT scan of the head showed thickened right parietal bone and a low-density lesion between bony layers. 3D CT of the skull showed bony protrusion of the right parietal bone. A cosmetic surgical procedure was performed for the patient, and biopsy of the bony lesion confirmed ossified cephalhematoma. We discuss diagnosis, pathogenesis, and treatment of ossified cephalhematoma.

We report a term infant born by emergency C-section for fetal bradycardia. Active labour was established at the time of section, resulting in the fetus being deeply impacted and difficult to extract. Baby was born pale and floppy but responded to inflation breaths. Antenatal scans were unremarkable. She was noted to have a depression measuring 4×4 cm in the right parietal area. Skull x-ray (figure 1) showed a depressed fracture of the right parietal bone. There was no …

A term baby was delivered by emergency caesarean section for failure to progress with an unstable lie. Forceps or vacuum extractor was not used. She was born in good condition requiring no resuscitation. Initial examination revealed a large depression over the right parietal bone measuring ∼6 cm in diameter and …

Intradiploic cavernous hemangioma of the skull is seen rarely. Intradiploic cavernous hemangiomas arise from the intrinsic vasculature of the bone and generally picks up at the fourth and fifth decades. In this report, we present a 16-year-old child who was admitted with a swelling lesion in the right parietal bone and diagnosed as cavernous hemangioma after total extirpation.

Purpose The aim of this investigation was to assess the effect of low magnitude high frequency (LMHF) mechanical vibrated stimulation on healing the defects surgically imposed on craniofacial bones. Materials and Methods Forty 12-week-old C3H strain mice were separated into surgical and non-surgical groups. The surgical groups had a reproducible surgical bony lesion prepared in their right parietal bone. Both groups were further subdivided into vibration (experimental) and non-vibration (control) groups at 3 time points (zero hours, 2 weeks, and 4 weeks). The vibration groups were subjected to LMHF mechanical stimuli (30 Hz with peak strain 5μϵ) via a vibration machine for 20 minutes a day for 5 days a week for a total of 28 days. The specimens were analyzed using micro-computer tomography (micro-CT). Results Micro-CT volumetric measurement showed that in the surgical defects groups there was a significant decrease in the volume of the healing lesion with time (P < .001) and the linear decrease was significantly more pronounced in the vibration-treated group than the nontreated group (P < .001). Micro-CT histomorphometric measurement showed that in the nonsurgical groups there was no significant difference in microstructures of bony trabeculae between vibration-treated and nontreated groups. Conclusion It is suggested that the introduction of LMHF mechanical stimuli in a healing bony lesion in the non-weight bearing bone significantly increases its healing capacity.

This study demonstrates interfacial changes of titanium miniplate/screw with normal calvaria and nonvascularized calvarial bone graft ensued from craniectomy in a 53-year-old female. In 18 months after operation, a right parietal bone containing an L-shaped miniplate with screws, 5 mm long and 2 mm in external diameter, was harvested, fixed, and embedded in methylmetacrylate. Fifteen micrometer thick sections were made by an EXAKT cutting-grinding system (Exakt Company, Hamburg, Germany), and reviewed under the bright field light microscope. The mean of the bone-contacting surface ratio (BCSR) in six screwed bone was 64.1%; 69.3% in normal bone, and 60.4% in grafted bone. The trabecular bone areas in 10 x 5 mm (50 mm2) rectangular area of diploe surrounding the screws was 43.02 mm2; 45.25 mm2 in normal calvaria; and 41.82 mm2 in grafted bone. The mean Ca/P peak-height ratio of the plated and screwed calvaria was 1.47 in a 9 mm wide zone around each screw; 1.37 in normal calvaria; and 1.51 in grafted calvaria. We concede that the effect of direct contact of titanium with screws onto the bone is as much as an osseous integration (osseointegration).

Telangiectatic osteosarcoma is rare malignant tumor causing aggressive bone destruction, though the skull is very rarely involved. We report a case in which the condition affected the skull of a 17-year-old male, involving the parietal bone and with intracranial and extracranial extension. CT and MR images depict an osteolytic lesion of the right parietal bone and an enhancing solid mass in the intracranial and extracranial portions. Matrix calcifications, periosteral reaction, and multiple fluid-fluid levels are seen within the masses.

The observations recorded in these notes were made upon the cranial cast which was submitted to me for examination by Dr. Smith Woodward, under whose direction the remains of the cranium were fitted together and the cast obtained from it. The accompanying sketch (fig. 11) represents the left norma lateralis, and will explain better than a description the extent of missing cranial wall. The greater part of the right parietal bone and a considerable part of the occipital were found, and it was possible to fit them into position. Thus the form and proportions of the whole brain can be estimated. The sharply-cut meningeal grooves upon the bones have produced upon the cast the whole pattern of the middle meningeal veins and arteries with great distinctness. The diagram shows the arrangement upon the left side: upon the right it conforms to Giuffrida-Ruggeri9s Typus 1. Unfortunately, there are only very slight indications of the arrangement of the furrows upon the surface of the cerebral hemisphere. Nevertheless many of them can be detected, if not by sight, by passing the finger over the surface and locating the depressions by touch. These features are represented (with considerable exaggerations so far as depth of shading is concerned) in the diagram (fig. 11) on the preceding page. At first sight, the brain presents a considerable resemblance to the well-known Palaeolithic brain-casts, and especially to those obtained from the Gibraltar and La Quina remains, which are supposed to be women9s. Like these casts this one is

During the past season we have spent much time in examining the Piltdown gravel, working round the margin of the area previously explored in detail. In proportion to the amount of material removed, however, discoveries were few. Rolled fragments of teeth of Rhinoceros and Mastodon , as highly mineralized as before, were again found in place in the dark gravel; and they seem to belong to the Pliocene species Rh. etruscus and M. arvernensis, already provisionally recorded. No human remains were met with; but a large piece of bone evidently worked by man compensates for much disappointment, and proves to be so singular that it is worthy of special description. This bone implement was found about a foot below the surface, in dark vegetable soil, beneath the hedge which bounds the gravel-pit, and within 3 or 4 feet of the spoil-heap whence we obtained the right parietal bone of the human skull. On being washed away, the soil left not the slightest stain on the specimen, which was covered with firmly-adherent pale-yellow sandy clay, closely similar to that of the flint-bearing layer at the bottom of the gravel. The bone, therefore, cannot have lain buried in the soil for any long period, and was almost certainly thrown there by the workmen with the other useless debris when they were digging gravel from the adjacent hole. It is much mineralized with oxide of iron, at least on the surface, and it agrees in appearance with some small fragments of bone which we

Congenital occlusion of the foramen of Monro is extremely rare. In a review of medical literature, only 6 verified case reports could be found (2, 4, 5, 7, 8,10). From 1964 to 1968, we encountered 4 new cases of proved congenital occlusion of this foramen, which we will report below, emphasizing their radiologic and surgical findings. Case Reports Case I: This 6-month-old girl was admitted to Children's Hospital, Cincinnati, because of numerous brief convulsive seizures since birth. There was slight tenseness of the open anterior fontanel, and the head did not transilluminate. Roentgenographically, the skull appeared asymmetrical with prominence of the right parietal bone. Needle puncture through the fontanel yielded a large amount of yellow fluid from the right lateral ventricle. The left lateral ventricle could not be entered. Ventriculograms showed a huge right lateral ventricle. On pneumoencephalography the next day no air entered the lateral, third, or fourth ventricles (Fig. 1). A large amount of ai...

[Read before the Section on Diseases of Children.] This is a soft, elastic, fluctuating tumor, generally painless, and situated upon one of the cranial bones. It takes place, it seems to me, with somewhat greater frequency than the literature of the subject would lead us to suppose. I have already seen six cases in twelve years' practice. It is stated by most writers, that in the great majority of cases, indeed in almost all, the tumors have been upon the right parietal bone, inasmuch as it is this bone that is exposed to the pressure of the rigid os uteri in the greatest number of deliveries. Contrary to the experience of other observers, five cases which I have seen have taken place upon the left parietal bone and one on the right. It has, in a few cases, been noticed upon both of the parietal bones, although this has not

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Summary In a series of 2,774 newborn infants observed over a period of fifteen months, sixty-nine, or 2.49 per cent, of them had a cephalhematoma. Of the sixty-four infants who were examined roentgenographically, sixteen, or 25 per cent, had a fracture of the parietal bone underlying the cephalhematoma In only one instance were symptoms other than the tumefaction observed; these were the result of an associated intracranial hemorrhage. This infant, with a cephalhematoma sufficiently large to produce an anemia, required transfusions of blood. The incidence of cephalhematomas would seem to be greater over the right parietal bone than over the left one and more common in male than in female infants. Statistical analysis of the data revealed that cephalhematomas, with orwithout a fracture of the skull, occurred more often in infants born of primiparous women, with the incidence being higher in infants delivered with forceps than in those delivered spontaneously.

In June, 1886, my little daughter, aged 8 years, while trying to drive a horse running at large, was kicked on the side of the head, the skull being fractured over the posterior superior portion of the right parietal bone, crushing the bone and driving it in, producing compression of the brain. I was absent from home at the time, and my friend Dr. Burns was called in; his opinion was that she would not live twelve hours. I was immediately telegraphed for, and on arriving at home in a few hours I found the child in a comatose condition, her pulse regular and about 110. I sent for Dr. Burns, and we soon went to work to remove the compressed bone, but after the removal of seven pieces of bone the comatose condition was not entirely relieved. She remained in a semi-comatose condition for five days. We found the

The syndrome of defects in the membranous bones, exophthalmos and diabetes insipidus has been recognized as a systemic manifestation of disturbed lipoid metabolism. This symptom complex was first described by Hand, 1 in 1893, who considered the disease to be a tuberculous granuloma of bones with dyspituitarism due to secondary hypophyseal implication. In Hand's case there was a soft yellow (xanthomatous) area about 1 inch in diameter involving the entire thickness of the right parietal bone of the skull. Later Schuller, in Vienna, in 1916 reported two additional cases with the characteristic roentgen findings in the skull and Christian 2 in 1919 described another case. Both Schuller and Christian stated the belief that the entire clinical picture was due to pituitary dysfunction. In 1925 Thompson, Keegan and Dunn 3 reported a case with complete autopsy. Rowland 4 in 1928 reviewed these cases and the related literature, described two new cases

Case 1. —T. P. was born Aug. 20, 1893, at Hospital of the Good Shepherd; weight 4% lbs. The mother was a primipara, labor was uneventful. History —On the second day jaundice occurred. On the same day a swelling appeared over the right parietal bone, followed soon by a similar tumor over the left parietal. Both increased in size and were limited and separated by the parietal suture until the fifth day. Dr. John Van Duyn photographed the child and aspirated the tumors, finding blood. The jaundice deepened, the stool became green, child grew weaker, and died on the ninth day. Autopsy. —Postmortem by Dr. Van Duyn showed infant very thin and yellow; the internal organs were normal. The tumors were beneath the pericranium and contained about six ounces of fluid clotted blood (Fig. 1). Case 2. —T. K. was born March 17, 1906; weight 9 lbs. History. —The labor

The following case of concussion of the brain furnishes an interesting clinical history and instructive operative findings: History. —M., male, aged 25, jockey by occupation, fell from his horse in a hurdle race and it is supposed was kicked in the head. Admitted to hospital March 7. Examination (ambulance notes). —When first seen the patient was unconscious, respiration stertorous, pulse full, slow and bounding; reacted to painful stimuli on either side; pupils were moderately dilated and unequal; right corneal reflex slower than left. The face was congested and there was a lacerated wound of the scalp over the right parietal bone. On the way to the hospital the patient's breathing ceased to be stertorous and he reached up with the left hand and unbuttoned undershirt. On being pinched, movements of the face were apparently equal. On arrival at the hospital he reacted slightly to painful stimuli in the right leg