Lucke (gap) + schadel (skull)
The luckenschadel (sometimes called "luckenschadel skull," although this is technically redundant) is a calvarial abnormality most often associated with a Chiari II malformation and a meningomyelocele.
The luckenschadel is an ossification disorder which leads to multiple deep pits in the membranous bones of the newborn skull (favoring the parietal and occipital bones). It has a classic radiographic "honeycomb" appearance (below), which is diagnostic.
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| Alternating regions of cortical fenestration, creating a "honeycomb" appearance, compatible with Luckenschadel. There is also scalp swelling. Vaginal delivery of these infants can be problematic since cranial pressure on a fenestrated skull can lead to intracranial hemorrhage. |
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| 3D CT reformats of luckenschadel |
The grooves in the skull do not necessary traverse the entire bone, and when limited to the inner table, they are called "craniolacunae." If palpable and involving both the inner and outer table, they are then referred to as "craniofenestrae." The "waviness" of the skull outline on axial imaging is detectable on obstetric ultrasound (below).
Developmentally, luckenschadel is similar to myelomeningocele, in that there is failure of normal bone formation over the brain. Some sources claim that it develops in part due to lack of normal cerebral ventricular distention due to an open neural tube defect in the Chiari II malformation. Over the first 6 months, the fenestrae fill in, and luckenschadel is a diagnosis that can only be made in neonates.
1. Vigliani, M. "The luckenschadel skull: a forgotten entity" Obstetrics and Gynecology: Volume 111(2, Part 2), February 2008, pp 562-565
2. Coley BD. "Ultrasound diagnosis of luckenschadel (lacunar skull)" Pediatric Radiology, Volume 30:2. pp 82-84.
