This 6 month old child has muliple sutural synostosis (sagittal suture and part of the lambdoid sutur) , and a Chiari I malformation.

Severe copper beaten skull appearance is present which is more remaniscient of a lacunar skull, however no myelomeningocoele is present (i.e not a Chiari II malformation) and axial imaging demonstrates the correlation of gyri with the overlying skull defects.

The patient was treated with surgery to open the sutures, and marked improvement to the skull shape and posterior fossa ensued.

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