DOI: https://doi.org/10.36347/sjmcr.2026.v14i11.029

Pages: 2533-2535

Background: Craniolacunia, also known as Lückenschädel or lacunar skull, is an uncommon developmental abnormality of the calvarium characterized by multiple irregular osseous lucencies separated by residual bony trabeculae. It is frequently associated with congenital abnormalities of the central nervous system and may be encountered in infants undergoing neuroimaging for hydrocephalus or other neurological manifestations. Case presentation: An 11-month-old female infant with a history of hydrocephalus treated with a ventriculoperitoneal shunt presented with signs of raised intracranial pressure. Non-contrast brain CT revealed severe tetraventricular dilatation. Bone-window images demonstrated multiple irregular calvarial lacunae of variable sizes, separated by preserved bony trabeculae, producing a characteristic reticulated appearance suggestive of craniolacunia (Lückenschädel). Further MRI evaluation may be considered to investigate associated congenital anomalies Discussion: CT is particularly useful for characterizing calvarial abnormalities and evaluating associated intracranial findings. Recognition of craniolacunia should prompt a systematic assessment for associated congenital malformations, particularly neural tube defects and abnormalities of the craniocervical junction. Differential diagnoses include prominent convolutional markings and other causes of calvarial remodeling. Conclusion: Craniolacunia is an important radiological finding in infants with neurological abnormalities. Careful assessment of the skull vault on bone-window CT images, combined with a comprehensive evaluation of the intracranial structures, is essential for accurate diagnosis and appropriate investigation of associated abnormalities.