Objective      To investigate the clinical features and therapeutic management for sinus pericranii in children.      Methods      A retrospective review of 12 children with sinus pericranii pathologically confirmed by surgical resection was performed. They were 9 males and 3 females

with an age ranging from 3 month to 9 years and 7 months (mean 2 years and 9 months). The lesion was located in the midline in 10 of 12 patients

including 4 in the parietal

3 in the occipital

and 3 in the frontal. The lesion of 2 patients was in a temporal off-midline. The characteristic feature of this abnormality was that its size depended on intracranial pressure and central venous pressure. All cases of sinus pericranii were of progressively enlarging tumors. Minimally invasive procedures were performed

such as tumor excision

resection of the communication site by electrocoagulation

and bone wax and fibrin sealant filling of the same site.      Results      CT scan showed a prominent soft tissue mass superficial to the thinning skull. Three-dimensional volume-rendered CT reconstruction (3D-CT) demonstrated multiple small diploic holes and erosion of the skull bone. The transcranial connection was visualized using CT angiography (CTA) or MR venography (MRV). The postoperative course was uneventful. The pathological examination showed the mass was of a thin-walled cystic lesion. Microscopic examination of the cystic mass revealed that the cystic mass was lined by a single layer of flattened endothelial cells or a connective tissue. All 12 patients were followed up for 6 months to 5 years

and the results showed no relapse or any complication.      Conclusion      Sinus pericranii in children has typical clinical manifestations and imaging features. Surgical resection obtains excellent or good outcome.