Assessment of roentgenographic lucencies of the skull: a systematic approach

A review of roentgenologic characteristics of cranial vault defects suggests these criteria as favoring benign etiology: solitariness and small size, parasagittal location, smooth edges, sclerosis of margin, peripheral vascularity, and presence of bone remnants within the lesion. The more of these criteria that are present, the greater is the likelihood of benignity. Conversely, the presence of multiple defects of large size or scores of defects of small size, ragged undermined edges, total bone penetration, lack of peripheral vascularity, of absence of marginal sclerosis is presuptive evidence of malignancy.