A probable example of cranial dysraphism from New Orleans, Louisiana

Abstract

AbstractCranial dysraphism, a pathological condition resulting from a neural tube defect, is a rarely reported condition in archaeological and clinical literature. A defect at bregma was identified on human remains recovered from New Orleans, Louisiana, when exhumation of several commingled bodies occurred in a paupers' cemetery in 2015. Initial speculation regarding the cause of the condition consisted of trauma, pathological condition, a natural variant, or the result of a congenital defect. A differential diagnosis was utilised to approach the breadth of potential causative factors, incorporating clinical information on the bony response of soft tissue defects common in modern reports. However, during a review of the bioarchaeological literature, an alternative explanation for the feature, one that did not result from typically reported causes, revealed that this observed defect was likely an example of the rarely reported condition known as cranial dysraphism. Through review of both clinical and bioarchaeological data, the resulting diagnosis observed here is supported through the unique characteristics that several other authors have identified as associated with cranial dysraphism. Unique features of this bony defect include the smooth walls of the depression, a saucer‐like shape with an anterior rim built up of cortical bone, lack of diploë exposure, a perforation at the base of the saucer, and the retention of cranial sutures. Although the defect also closely resembles the bony response to a cyst, the perforation and anterior rim are supportive of its diagnosis as a cranial dysraphism. This case study of a single occurrence of cranial dysraphism is reported to assist practitioners in differentiating between this condition and other potential causes of anomalies of similar appearance.