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Correspondence to Dr Abraham M Ittyachen, [email protected]
Description
The human skull has several sutures which separate the bones of the skull but allow the bones to grow in synchrony with the growth of the brain. In the normal case, the sutures close only after the growth of the brain is complete. But if one or other of the sutures close early, this can cause an abnormally shaped skull with or without an increase in the intracranial tension. Premature fusion of sutures (craniosynostosis) can occur in a number of syndromes.1 One typical manifestation of craniosynostosis is what has come to be described as the ‘copper beaten skull’ appearance. Copper beaten skull is more commonly described in children.2–5 Here we describe a 24-year-old man who presented to the medicine outpatient (OP) with cough, fever and rhinitis and was incidentally detected to have a copper beaten skull.
A 24-year-old man presented to the medicine OP with 2 weeks history of cough, fever and rhinitis. He was partially treated from outside and the fever had subsided. But he continued to have cough. Physical examination was within normal limits. Posteroanterior chest radiograph was unremarkable. As there was a clinical suspicion of chronic sinusitis, radiograph of the sinuses (Water’s view or occipitomental view) (figure 1A) was also obtained. It did not show any features of chronic sinusitis. This was followed up with an anteroposterior (AP)...