Diagnostic and therapeutic considerations for sinus pericranii

Sinus pericranii is one of the differential diagnoses which should be considered when a physician encounters a patient with a subcutaneous soft scalp mass. Sinus pericranii is a rare vascular anomaly of the venous drainage between the intracranial and extracranial systems via the diploe of the skull. We describe here a 16-year-old female with sinus pericranii following minor head trauma four years prior. CT and MRI scans revealed heterogeneous enhancement of the lesion and three-dimensional CT showed a crater-like depression and multiple honeycomb diploic holes in the skull. Angiography was normal, whereas percutaneous sinusography revealed a connection between the lesion and the superior sagittal sinus. The patient underwent surgery to disconnect her diploic veins from the lesion under general anaesthesia, and her postoperative course was uneventful after six months follow-up. To avoid profuse bleeding and air emboli and to ameliorate cosmetic problems, a specific diagnosis should be made to plan appropriate treatment.