[Congenital skull depression. Report of 2 cases]

Congenital depression of the fetal skull is a rare lesion (1 to 2.5 per 10,000 births) resulting in an asymmetrical skull. This depression is caused by exaggerated or prolonged pressure applied to the fetal head in utero or during delivery. Two types of congenital skull depression have been described: deformity without fracture and depression with fracture, the more common form. Congenital skull depression is important because it may be associated with underlying brain injury, especially when the depression is associated with fracture. The simple permanent cosmetic deformity may also constitute a complication. CT scan can now rule out intracranial complications and in this case, a conservative management is reasonable treatment option. The observation period should not exceed six months. After this period, orthopedic or surgical management may be indicated because spontaneous elevation of depression is uncommon after six months. The authors report two cases of congenital skull depression with deformity without fracture. The pathogenesis and treatment are discussed.