Cutis verticis gyrata.

Acta Neurologica Taiwanica Vol 15 No 2 June 2006 From the Departments of Neurology and Radiology, Lotung St Mary’s Hospital, I-Lan, Taiwan. Received October 19, 2005. Revised October 25, 2005. Accepted October 31, 2005. Reprint requests and correspondence to: Zen-Yong Chen, MD. Department of Neurology, Lotung St Mary’s Hospital, No. 160, Chong-Cheng S. Road, I-Lan, Taiwan. E-mail: [email protected] A 34-year-old man was found to have several soft skin folds on the scalp during a routine health examination. Because of the difficulty during delivery, the patient was born with a vacuum extractor at full term. Psychomotor delay was subsequently noted. He was diagnosed to have quadriplegic cerebral palsy and mental deficiency in early childhood. The folds on the scalp developed gradually in the second decade and became stable thereafter. There is no history of seizure. The physical examination of the patient at 34 years of age revealed the following information. His body weight was 35.6 kg, with a body hight of 151 cm, and a head circumference of 49 cm. Soft skin folds and furrows running in an anteroposterior direction were present in the vertex and upper occipital regions. Bilateral divergent, alternative strabismus was noted. He was severely dysarthric with incomprehensible speech, but his verbal comprehension was relatively preserved. He was cooperative and could follow simple verbal commands and understood the concepts of size and color. Athetosis and spasticity were both present in his upper extremities. His legs have had been in flexion contractures for many years. Routine blood and urine tests were normal. Prolactin, thyroid hormone (T4), thyroid stimulation hormone, electrolytes, and blood sugar (fasting and postprandial) were normal. A computed tomographic (CT) scan of the head confirmed the abnormalities in the scalp tissues. Focal hypodensity in bilateral frontal parasagital regions with widening of cortical sulci over corresponding anterior frontal areas were found, presumably due to old insult. Cutis verticis gyrata (CVG) is a rare condition characterized by the formation of furrows and folds on the scalp. This neurocutaneous disorder is rarely menCutis Verticis Gyrata