The "Hair-Collar" Sign A female neonate was born through vaginal delivery at 39 weeks of gestation. At birth, an elastic protruding hairless nodule measuring up to 1.5 cm in diameter, without enlargement while crying, was noticed on the vertex of the scalp (Figure). A ring of high density, dark, coarse, and long hair was noticed around the nodule, forming a "hair collar." Brain magnetic resonance imaging revealed a lobulated cystic lesion with a stalk through the parietal calvarium. She received resection of the nodule with repair of the periosteum at the age of 3 months, and a pathology study confirmed the diagnosis of meningoencephalocele.After Commens et al described the "hair-collar sign" in 1989, 1 it has been reported to be associated with encephalocele, meningocele, 2 aplasia cutis, 3,4 heterotopic glial tissue, or meningothelial hamartoma. 5,6 Rarely, association with vascular malformation such as sinus pericranii has also been reported. 7 As with this case, cranial imaging is recommended before any surgical intervention to survey intracranial abnormalities. n