Beaten Silver (Beaten Brass) Pattern

Leo Davidoff ¹ , in 1936, studied the skull roentgenograms of nearly 2500 normal individuals in an attempt to understand the significance of the appearance of the convolutional markings upon the inner table of the skull. This work was done at the Neurological Institute in New York. The patients had an age range from 3 months to 18 years. The ‘appearance of patchy areas of diminished density in the roentgenograms of the skull in certain cases is a matter of frequent experience. These areas are assumed to be the result of impressions of the cerebral convolutions upon the inner table of the skull, and when accompanied by pressure atrophy of the sella turcica or separation of the cranial sutures, or both, are indications of increased intracranial pressure. When the intracranial pressure is great, these markings may resemble beaten silver.’ ¹ (Figure 1). He emphasized that this appearance could be normal in growing children who did not have any other evidence of increased intracranial pressure. The presence of other signs of increased intracranial pressure was most important. Figure 1 ‘Skull X-ray of 7-year-old child’<xref ref-type="bibr" rid="ref5_1"> ¹ </xref> showing beaten silver or brass pattern. Reprinted from Davidoff. Convolutional digitations seen in the roentgenograms of immature human skulls. <italic>Bull. Neurol. Inst</italic> NY, <bold>5, 61–71</bold> https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig5_1_B.jpg"/>