1. DR. ATM HASIBUL HASAN MD (Neurology) thesis part student, DMCH DISEASES OF THE SKULL AND SKULL BONES 2. SPECIES RULING THE WORLD 3. ??? 4. HUMAN AS THE RULER 5. SKULL IN SPECIES 6. EVOLUTION 7. Imaging of Skull Disorders related to Skull Disease of Calavaria Disease of Base of Skull TOPICS FOR DISCUSSION 8. NORMAL VARIATION OF SKULL 9. BRACHYCEPHALIC 10. MESOCEPHALIC DOLICOCEPHALIC SKULL VARIATION 11. X ray CT Scan MRI IMAGING MODALITIES 12. X-RAY SKULL 13. CT SCAN 14. 3D CT 15. 3D VRT 16. 3D VRT 17. 3D VRT SKULL BASE 18. 3D PRINT 19. MRI 20. MRI 21. Structural Traumatic Vascular Inflammatory Neoplastic Systemic Disease DISEASES OF SKULL 22. DISEASES OF CALAVARIA 23. Failure of Development: Anencephaly Microcephaly Abnormal Development: Craniosynostosis Craniofacial Dysmorphic Syndrome DEVELOPMENTAL DISORDERS 24. Features: (NINDS) Blind Deaf Unaware of surroundings Unable to feel pain Cause: Diet: Lack of folic acid Drugs & Toxins Diagnosis: (Screening) USG AFP Prognosis: Death within hours to days if not still born ANENCEPHALY 25. Definition: o HC >2SD below the mean Cause: Prenatal Congenital: Isolated, Syndromic Acquired: Injury, Infection, Drug Postnatal Syndromic: Acquired: Injury, Infection, Toxin, Malnutrition Presentation: Developmental delay Intellectual disability Varying degree of motor deficit Seizure MICROCEPHALY 26. CRANIOSYNOSTOSIS 27. SCAPHOCEPHALY 28. TRIGONCEPHALY 29. PLAGIOCEPHALY 30. BRACHYCEPHALY 31. 3D CT 32. TURRYCEPHALY 33. CLOVERLEAF DEFORMITY 34. Syndrome Craniofacial feature Association CROUZON (Craniofacial dystosis) CSO of Coronal and Basal Skull sutures Maxillary Hypoplasia Shallow Orbit Proptosis Rarely Hydrocephalus APERT(Acrocephalosyndactyly) Same Syndactyly of digit 2, 3, 4 Shortened Upper Limb Hydrocephalus KLEEBLATTSHADEL CSO with Trilobular skull May be associated with APERT CRANIOFACIAL DYSMORPHIC SYNDROME 35. GENETIC BASIS 36. Facts: AD Branchial arch syndrome (1st Arch) Early fusion of skull and facial bones Low set ears, craniosynostosis, exopthalmos, hypertelorism, hypoplastic maxilla with relative prognathism. PDA, Coarctation aorta. CROUZON SYNDROME 37. Facts:(Acrocephalosyndactyly) Affects 1st Branchial arch. Acro Cephalo= Peaked Head Syndactyly= Webbing of fingers and toes Different forms of Craniosynostosis may be present APERT SYNDROME 38. DISEASES OF SKULL BASE 39. Congenital Dermoid and epidermoid Meningoencephalocoele Nasal Glioma Developmental Chiari malformation Basilar impression Occipitalization of Atlas Infec/Inflammatory Tuberculosis, Sarcoidosis Wegners granulomatosis Mucocoele Invesive fungal lesion Tumor Sinonasal: Juv AF, Sq Ca, Adeno Ca, Melanoma, Lymphoma Intracranial: Meningioma, Schwannoma, Pituitary Adenoma, Craniopharyngioma Trauma DISORDERS OF SKULL BASE 40. Der moid Epider moid CONGENITAL DISORDERS 41. A 53-year-old female presented with two years history of frequent and intense headaches with left nasal obstruction, recurrent post nasal drip and a gradually developing anosmia and left intermittent watery rhinorrhea that worsens when she cough, sneezes and defecate. CLINICAL SCENARIO 42. MENINGOENCEPHALOCELE 43. Chiari malformation Occipitalization of atlas Basilar Impression DEVELOPMENTAL DISORDERS 44. TRAIT CHIARI I CHIAR-II Usual Age Young Adult and Older Children Infant Usual Presentation Cervical pain, Suboccipital Headache Myelopathy Lower Brainstem Symptoms Central Cord Symptoms Features of Brainstem Dysfunction (Difficulty in swallowing, stridor, apnoea) Progressive hydrocephalus Weakness of extremity Caudal Descend Tonsil Inferior vermis, Medulla, 4th Ventricle Caudal Descend of Medulla Unusual Yes Spina Bifida Unusual Rarely Absent Hydrocephalus