Congenital Subgaleal Cysts over the Anterior Fontanelle in Nigerians

Congenital subgaleal cysts over the anterior fontanelle in Nigerians. Eighteen cases of a congenital cystic swelling located over the anterior fontanelle are described in Nigerian patients who were otherwise clinically normal, There was a female: male ratio of 2: 1. Radiologically and at operation, the cysts showed no evidence of intracranial connexion. Excision was curative. Of 14 cases which were histologically verified, all were dermoid cysts except one in which nerve tissue was present suggesting an encephalocele. Air cystography was the most useful diagnostic procedure. A congenital midline sincipital cystic swelling of the head inevitably arouses in the clinician's mind the possible existence of some form of meningo-encephalocele, or of herniation of brain substance or its enveloping membranes through a defect in the calvarium. Encephalocele of the anterior fontanelle is a rarity, none being found in reported series of encephaloceles from Thailand (Suwanwela and scalp intracranial pressure (®AlUSUAL SHAPE ( ENCEPHALOCEL anterior fontanelle and under the galea aponeurotica. It is a soft, fluctuant, non-tender mass which trans-illuminates, and the edges of the anterior fontanelle may or may not be palpable beyond its broad sessile base (Fig. 2). Between 1959 and 1969, 18 examples of this peculiar cystic lesion were encountered in Nigerians attending this hospital. In all except 2 cases, relatively wide (broadest) cyst wall narrow base of neck extrinsic i scal