Accessory occipital suture

Case contributed by Dr Dalia Ibrahim

Presentation

An infant fell on the head.

Patient Data

Gender: Male
CT

No evidence of calvarial fractures.

No evidence of intracranial hemorrhage.

Normal CT scan of the brain.

Right positional plagiocephaly.

An incidental finding of an accessory left occipital suture is noted.

Case Discussion

Accessory sutures are common in parietal and occipital bones.

It is important to know these anatomic variations, mainly in the setting of head trauma in children, where it could be difficult to differentiate accessory sutures from skull fractures.

To differentiate them from skull fractures, those points are useful:

Accessory sutures are usually:

  • bilateral
  • make a "zig-zag" pattern with interdigitations
  • have sclerotic borders similar to major calvarial sutures

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