Untreated or irregularly treated children develop significant hemolytic (Chipmunk) facies due to extramedullary erythropoiesis results in expansion of bone marrow space, including fronto-parietal and occipital bossing with a hot cross bun appearance of skull (Caput quadratum), hair on end appearance of skull results from widening of the diploic
spaces, depressed bridge of nose, malar prominence, and malocclusion of teeth with protrusion of maxillary teeth, distortion and osteoporosis of ribs and vertebrae, pathological fracture of long bones, splenomegaly with its complications hypersplenism, hepatomegaly, gallstone and chronic leg ulcers.
vein was significantly dilated with a rich blood supply.
It also receives blood from diploic
, meningeal and emissary veins.
have classified primary extradural meningiomas into four types: Type I (epidural), tumor located between the dura mater and the inner calvarial table; Type II (calvarial or diploic
), located between the outer and the inner calvarial table; Type III (extracranial), located outside the outer calvarial table; and Type IV (mixed), tumor extending from the dura to extracalvarial space .
Widening of the interdental spaces, and an expanded, heterogeneous appearing diploic
space was also identified (Figure 1).
Because the veins of the frontal sinus mucosa communicate through the diploic
veins with the periosteum veins and with the dural venous plexus, septic trombi can potentially migrate from the frontal sinus and propagate to the periosteum and to the dura (5).
CT head showed open anterior fontanelle, large cranial vault with thin diploic
space, and no abnormality in the brain (Figure 2(c)).
In our study, we identified skull fractures in 78% of children, which is a significant finding as the skull in children has abundant diploic
veins making these the main source of bleeding.
The excavation, treatment and study of human skeletal remains, Brothwell notes: "if the edges of the hole are rounded and the exposed diploic
spaces of the spongy inner tables shows signs of closing or have closed" (8).
(5) On the other hand, plasmacytomas often present as solitary intra- and extra-cranial masses that bridge the diploic
site of origin.
They had sclerotic borders on plain X-ray films borders, involvement of both diploic
tables, and a density similar to brain parenchyma on CT scanning  yet similar to dermoid cysts on MRI .
It is characterised by numerous oval lucencies (a honeycomb appearance about 2 cm in diameter) of the inner table and diploic