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An Aberrant Line on CT Head: The Mendosal Suture
Jigish Ruparelia1, Rajnish Patidar1, Jaskaran Singh Gosal1
1Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Journal of Neurosciences in Rural Practice
|August 6, 2020
Summary
An accessory occipital suture, or mendosal suture, is a rare anatomical variation. Recognizing this variant is crucial to prevent misdiagnosis as a fracture in pediatric imaging.
Area of Science:
- Anatomy
- Radiology
- Pediatric Imaging
Background:
- Knowledge of anatomical variations is vital in clinical practice.
- Occipital bone variations, including accessory sutures, are common in infants and children.
- Accessory sutures can be mistaken for fractures, necessitating accurate identification.
Purpose of the Study:
- To discuss the radiological findings of an accessory occipital suture in a 14-year-old child.
- To describe the pathophysiology and clinical implications of this mendosal suture.
- To emphasize the importance of differentiating this variant from fractures.
Main Methods:
- Case report of a 14-year-old child presenting with mastoiditis and brain abscess.
- Radiological assessment including computed tomography (CT) scans.
- Three-dimensional CT with volume rendering technique (VRT) for detailed visualization.
Main Results:
- Identification of an accessory occipital suture (mendosal suture) in the patient.
- The suture was noted in the context of mastoiditis and brain abscess.
- CT and 3D CT with VRT confirmed the accessory suture and aided diagnosis.
Conclusions:
- Accessory occipital sutures are important anatomical variants to recognize in pediatric radiology.
- Misdiagnosis as a fracture must be avoided, especially in cases with concurrent infections.
- Advanced imaging techniques like 3D CT VRT are valuable for accurate detection and diagnosis.
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