Copper beaten skull

Changed by Jeremy Jones, 25 Feb 2023
Disclosures - updated 6 Dec 2022: Nothing to disclose

Updates to Article Attributes

Body was changed:

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

There are no clinical features specific and unique to a copper-beaten skull, as the osseous features are on the skull's inner surface of the skull. As theThe appearance ismay be associated with skull abnormalities (e.g. craniosynostosis) and raised intracranial pressure in children,; the clinical presentation may reflect these underlying causes.

It is important to note that a copper-beaten appearance can be seen in normal children during periods of rapid brain growth between 2-3 and 5-7 years 5

Pathology

Raised intracranial pressure was once thought to be the single causative mechanism behind increased inner table markings that give rise to the copper-beaten skull appearance. However, this appearance is not specific, and other causes are possible, includinginclude:

Importantly, although the degree of prominance of copper beaten appearance doesmay correlate with higher raised intracranial pressure, this correlation is not poor and this feature it should not be used to estimate or exclude abnormalities of intracranial pressure 5.

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:

  • -<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>There are no clinical features specific and unique to a copper-beaten skull as the osseous features are on the inner surface of the skull. As the appearance is associated with skull abnormalities (e.g. craniosynostosis) and <a href="/articles/raised-intracranial-pressure">raised intracranial pressure</a> in children, the clinical presentation may reflect these underlying causes. </p><p>It is important to note that a copper-beaten appearance can be seen in normal children during periods of rapid brain growth between 2-3 and 5-7 years <sup>5</sup>. </p><h4>Pathology</h4><p>Raised intracranial pressure was once thought to be the single causative mechanism behind increased inner table markings that give rise to the copper-beaten skull appearance. However, this appearance is not specific and other causes are possible, including:</p><ul>
  • +<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>There are no clinical features specific and unique to a copper-beaten skull, as the osseous features are on the skull's inner surface. The appearance may be associated with skull abnormalities (e.g. craniosynostosis) and <a href="/articles/raised-intracranial-pressure">raised intracranial pressure</a> in children; the clinical presentation may reflect these underlying causes.</p><p>It is important to note that a copper-beaten appearance can be seen in normal children during periods of rapid brain growth between 2-3 and 5-7 years <sup>5</sup>. </p><h4>Pathology</h4><p>Raised intracranial pressure was once thought to be the single causative mechanism behind increased inner table markings that give rise to the copper-beaten skull appearance. However, this appearance is not specific, and other causes include:</p><ul>
  • -</ul><p>Importantly, although the degree of prominance of copper beaten appearance does correlate with higher raised intracranial pressure, this correlation is not poor and this feature should not be used to estimate or exclude abnormalities of intracranial pressure <sup>5</sup>. </p><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>
  • +</ul><p>Importantly, although the degree of prominance of copper beaten appearance may correlate with higher raised intracranial pressure it should not be used to estimate or exclude abnormalities of intracranial pressure <sup>5</sup>.</p><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>

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.