Normal skull thickness has been measured in a general hospital population of 300 blacks and 200 whites in America. In both groups, there is a rapid increase in skull thickness during the first two decades of life, followed by a small uniform increase reaching a peak in the fifth and sixth decades. The sex differences are variable, but in certain age groups the females in both races have significatly thicker parietal and occipital bones than their male counterpart. The frontal bone is thicker in the white male than in the black, and the parietooccipital thicker in the blacks than in the whites. Some suggestions are offered to explain the sex and racial difference noted.

Adeloye, A. and Odeku, E. L. (1971). Archives of Disease in Childhood, 46, 95. Congenital subgaleal cysts over the anterior fontanelle in Nigerians. Eighteen cases of a congenital cystic swelling located over the anterior fontanelle are described in Nigerian patients who were otherwise clinically normal, There was a female: male ratio of 2: 1. Radiologically and at operation, the cysts showed no evidence of intracranial connexion. Excision was curative.Of 14 cases which were histologically verified, all were dermoid cysts except one in which nerve tissue was present suggesting an encephalocele.Air cystography was the most useful diagnostic procedure.

✓ This paper reports the spontaneous extrusion of the abdominal portion of a ventriculoperitoneal shunt through the umbilicus. Some of the possible predisposing factors are discussed.

Fifty-eight patients with occipital encephalocoeles were retrospectively examined. These comprised about one-half of the cases seen and evaluated for treatment at the University College Hospital, Ibadan, Nigeria, between January 1973 and December 1987. There was a female-to-male preponderance of 2:1. Of the patients 91% were treated during infancy. Only one patient was precluded from surgery because his large ulcerated lesion was associated with severe microcephaly and neonatal sepsis, to which he succumbed. About four-fifths of the lesions exceeded 5 cm in diameter. The operative mortality was 6%, all deaths occurring in patients who were neonates at the time of surgery and whose hernia sacs contained brain substance. Clinically apparent hydrocephalus was more frequently encountered postoperatively, than preoperatively. Developmental delay was apparent in 5 of the 13 patients in whom developmental milestones were assessed during follow-up. For most patients, the follow-up period was short, possibly a reflection of the poor prognosis of the disease.