Bullhorn Appearance of Skull in a Follow-Up Case of Craniosynostosis

Abstract Craniosynostosis is a craniofacial developmental anomaly resulting from the premature fusion of single or multiple skull sutures. It can have a syndromic (approximately 25%) or non-syndromic association (approximately 75%). Premature fusion of sutures can lead to developmental delays and cosmetic abnormalities of the calvarium. Their management involves surgical removal of the fused suture lines. Surgical correction, however, can lead to several complications such as hematomas, dural tear, and cerebrospinal fluid (CSF) leaks, etc. We present an 8-month-old child who presented with clinical features of non-syndromic craniosynostosis. He underwent “Pi” stripping 3 months ago. On follow-up, he developed two symmetrical bilateral globular swellings over the coronal sutures, 2 months after the first surgery. The swellings gave the appearance of a “bull horn.” Imaging with a CT brain was suggestive of hydrocephalous. A low-pressure ventriculoperitoneal shunt was placed. The postoperative period was uneventful, with resolution of the swellings and improvement in the craniofacial cosmetic appearance.