Acquired lacunar skull deformity following ventriculoperitoneal shunt placement

A female infant developed hydrocephalus as a result of intraventricular hemorrhage related to premature birth. Radiography showed no sign of lacunar skull deformity (LSD). Lateral and fourth ventricle ventriculoperitoneal shunts were placed. The fourth ventricle shunt required replacement at age 3 years. Radiography and computed tomography showed LSD. Follow-up radiography at age 8 years showed the LSD was becoming unclear. LSD generally appears before birth, and disappears shortly after birth. LSD is most commonly associated with spina bifida cystica or encephalocele. This case of acquired LSD indicates that abnormal disorganized collection of collagen fibers of the skull plates may be triggered by iatrogenic intracranial hypotension even after infancy.