Luckenschadel skull: a forgotten entity

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Pediatric Surgery

Background:

• Luckenschadel skull is a rare ossification disorder characterized by a fenestrated fetal skull.
• It is frequently associated with Chiari II malformation and meningomyelocele, indicating complex congenital anomalies.
• Antenatal diagnosis of neural tube defects should prompt consideration of associated skull ossification abnormalities.

Observation:

• A case report details a fatal subgaleal hemorrhage in a full-term infant.
• The infant had undiagnosed Chiari II malformation, meningomyelocele, and luckenschadel skull.
• Delivery was complicated by attempted vacuum and forceps extraction due to fetal distress.

Findings:

• The study highlights a rare but severe complication of subgaleal hemorrhage in an infant with a constellation of congenital anomalies.
• The association between luckenschadel skull, neural tube defects, and potential delivery complications is emphasized.
• The case underscores the importance of thorough prenatal evaluation and awareness of associated conditions.

Implications:

• Obstetricians must be vigilant for luckenschadel skull in fetuses diagnosed with neural tube defects.
• The potential clinical significance of luckenschadel skull, particularly during operative delivery like vacuum extraction, warrants further investigation.
• This case emphasizes the need for careful management of deliveries involving fetuses with complex congenital anomalies to mitigate risks such as hemorrhage.