Acalvaria: A rare congenital malformation
A 1-month-old female infant presented with soft, lax skull without any scalp abnormality. The baby was born at term by cesarean section and was second issue of consanguineous marriage, the first one being a male. The available antenatal record suggested a normal ultrasound examination and the other complications of pregnancy including any history of drug intake, radiation exposure, etc., were absent. The post-natal history suggested normal milestones and development for age without any other clinical symptoms.\nOn examination, the baby appeared active weighing 3,910 g with head circumference of 35 cm. The skull and face appeared normal on inspection with healthy skin cover. On palpation, the frontal, temporal, and occipital bones were absent in upper part, whereas parietal bones could not be palpated. The facial bones and rest of the physical examination were normal without any associated anomaly. Neurological assessment for age suggested no abnormality. The roentgenogram of skull suggested complete absence of parietal bones, and the frontal, occipital, and temporal bones were not visualized in upper aspect []. The computed tomography scan of brain confirmed the bony defect with presence of normal cranial contents and ventricular system [].\nThe baby was managed conservatively with a vigilant examination on close follow-up along with parental counseling and reassurance. The patient is presently having normal development without any apparent neurological abnormality on regular follow-up for the last 2 months.