Extensive Aplasia Cutis Congenita with Calvarial Defect and Superior Sagittal Sinus Exposure in a Term Neonate: A Case Report of Successful Healing with Conservative Management.
Hussein Salad Yusuf, Abdirisak Ali Abukar, Mohamed Said Adan et al.
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Case in brief
A term male neonate presented with an approximately 4 × 4 cm midline frontoparietal scalp defect involving the skin and calvarium, with the superior sagittal sinus exposed. CT showed a large congenital calvarial defect but no major intracranial abnormality. Clinically stable, he received conservative wound care with intravenous ampicillin, topical nitrofurazone and rifampicin, and twice-daily saline-moistened gauze dressings. Serial assessments showed granulation and epithelialization without documented wound infection or sepsis. After eight months, the lesion was nearly completely epithelialized, with mature scarring, residual crusting, and cicatricial alopecia.
What made this case unusual
The extensive defect exposed the superior sagittal sinus, yet progressive closure occurred with conservative wound care in this clinically stable neonate.
Diagnostic / clinical pearl
For extensive aplasia cutis with calvarial and venous-sinus exposure, assess bleeding, infection, tissue depth, neurological status, and reconstructive feasibility; conservative care requires close monitoring and readiness to escalate.
Why it matters
The outcome illustrates that conservative management can achieve closure in an individual stable neonate, but does not establish it as preferable to surgery; management must be individualized.