Copper beaten skull
Updates to Article Attributes
Copper beaten skull, also known as beaten silver skull or beaten brass skull, refers to the prominence of convolutional markings (gyral impressions on the inner table of the skull) seen throughout the skull vault.
Clinical presentation
The appearance of a copper beaten skull is, once though to be associated with raised intracranial pressure in children. Convolutional markings may, is now widely accepted to be a normal but are usually confined to the posterior part of the skull's inner tablevariant caused by rapid brain growth between 2-3 and 5-7 years.
Pathology
Raised intracranial pressure is (at least in part)was once though to be the causative mechanism behind increased inner table markings that give rise to the copper beaten skull appearance. HenceHowever, this appearance is not specific for raised intracranial pressure. One still should consider the possibility a pathology that causes raised intracranial pressure may be the primaryas a possible cause of copper beaten skull; these. These causes include, but are not limited to:
Radiographic features
Rather than the inner table of the skull being smooth, there are convolutions that overlie the gyri. As described above (and seen in the differential diagnosis case), convolutional changes may be normal if they are confined to the posterior calvaria and are subtle.
3D volume-rendered reformats demonstrate a calvaria with similar appearances to hand-beaten copper pot bottoms.
Differential diagnosis
On imaging consider:
A normal variant
-<p><strong>Copper beaten skull</strong>, also known as <strong>beaten silver skull</strong> or <strong>beaten</strong><strong> brass skull</strong>, refers to the prominence of <a href="/articles/convolutional-markings">convolutional markings</a> (gyral impressions on the inner table of the skull) seen throughout the <a href="/articles/cranial-vault">skull vault</a>.</p><h4>Clinical presentation</h4><p>The appearance of a copper beaten skull is associated with <a href="/articles/raised-intracranial-pressure">raised intracranial pressure</a> in children. Convolutional markings may be normal but are usually confined to the posterior part of the skull's inner table.</p><h4>Pathology</h4><p>Raised intracranial pressure is (at least in part) the causative mechanism behind increased inner table markings that give rise to the copper beaten skull appearance. Hence, a pathology that causes raised intracranial pressure may be the primary cause of copper beaten skull; these include, but are not limited to:</p><ul>-<li><a href="/articles/craniosynostosis">craniosynostosis</a></li>-<li><a href="/articles/obstructive-hydrocephalus">obstructive hydrocephalus</a></li>-<li><a href="/articles/hypophosphatasia">hypophosphatasia</a></li>-<li><a href="/articles/brain-tumours-in-infancy">intracranial masses</a></li>-</ul><h4>Radiographic features</h4><p>Rather than the inner table of the skull being smooth, there are convolutions that overlie the gyri. As described above (and seen in the differential diagnosis case), convolutional changes may be normal if they are confined to the posterior calvaria and are subtle.</p><p>3D volume-rendered reformats demonstrate a calvaria with similar appearances to hand-beaten copper pot bottoms.</p><h4>Differential diagnosis</h4><p>On imaging consider:</p><ul>-<li><a href="/articles/convolutional-markings">convolutional markings</a></li>-<li><a href="/articles/luckenschadel-skull-2">Luckenschadel skull</a></li>- +<p><strong>Copper beaten skull</strong>, also known as <strong>beaten silver skull</strong> or <strong>beaten brass skull</strong>, refers to the prominence of <a href="/articles/convolutional-markings">convolutional markings</a> (gyral impressions on the inner table of the skull) seen throughout the <a href="/articles/cranial-vault">skull vault</a>.</p><h4>Clinical presentation</h4><p>The appearance of a copper beaten skull, once though to be associated with <a href="/articles/raised-intracranial-pressure">raised intracranial pressure</a> in children, is now widely accepted to be a normal variant caused by rapid brain growth between 2-3 and 5-7 years. </p><h4>Pathology</h4><p>Raised intracranial pressure was once though to be the causative mechanism behind increased inner table markings that give rise to the copper beaten skull appearance. However, this appearance is not specific for raised intracranial pressure. One still should consider the possibility a pathology that causes raised intracranial pressure as a possible cause of copper beaten skull. These causes include but are not limited to:</p><ul>
- +<li><p><a href="/articles/craniosynostosis">craniosynostosis</a></p></li>
- +<li><p><a href="/articles/obstructive-hydrocephalus">obstructive hydrocephalus</a></p></li>
- +<li><p><a href="/articles/hypophosphatasia">hypophosphatasia</a></p></li>
- +<li><p><a href="/articles/brain-tumours-in-infancy">intracranial masses</a></p></li>
- +</ul><h4>Radiographic features</h4><p>Rather than the inner table of the skull being smooth, there are convolutions that overlie the gyri. As described above (and seen in the differential diagnosis case), convolutional changes may be normal if they are confined to the posterior calvaria and are subtle.</p><p>3D volume-rendered reformats demonstrate a calvaria with similar appearances to hand-beaten copper pot bottoms.</p><h4>Differential diagnosis</h4><p>On imaging consider:</p><ul>
- +<li><p>A normal variant</p></li>
- +<li><p><a href="/articles/convolutional-markings">convolutional markings</a></p></li>
- +<li><p><a href="/articles/luckenschadel-skull-2">Luckenschadel skull</a></p></li>
References changed:
- 5. Tuite G, Evanson J, Chong W et al. The Beaten Copper Cranium: A Correlation Between Intracranial Pressure, Cranial Radiographs, and Computed Tomographic Scans in Children with Craniosynostosis. Neurosurgery. 1996;39(4):691-9. <a href="https://doi.org/10.1097/00006123-199610000-00007">doi:10.1097/00006123-199610000-00007</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/8880760">Pubmed</a>
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