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The copper-beaten skull (also known as beaten silver or copper-hammered skull) refers to a prominent convolutional (gyral) impression of the cerebral gyri on the inner table of the skull, seen on skull radiographs or CT. These impressions resemble beaten metal—hence the name.
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Seen as multiple linear, radiolucent markings on the inner table of the calvarium
Best appreciated on:
Typically involves:
Plain radiography:
(a) X-ray of the skull in a 3 year old male child presenting with a history of seizure. The skull resembles a beaten piece of metal with its waxing and waning levels of opacities. Note the distinctly small size of the cranial vault, consistent with microcephaly. There is a complete absence of any suture lines as well, confirming the diagnosis of Craniosynostosis. (b) Note the bevelling of the inner table of the cranium (arrows). This is caused by a growing brain against a rigid cranial vault secondary to the premature closure of all the major suture lines.
Case courtesy Dr Nabarun Das, MD // 2025
CT imaging:
(a) Axial NCCT of the brain of the same case demonstrates diffuse compression of the pediatric brain against a microcephalic skull characterized by diffuse effacement of all cortical sulci. (b) 3D-reformation image of the skull demonstrates the bevelling along the inner table of the cranium secondary to the gyral impression of the brain on the skull
Case by Dr Abhineet Dey // 2025
| Physiologic | Pathologic |
|---|---|
| Normal in children (up to age 10) | Craniosynostosis (esp. multisutural) |
| Normal variant with skull growth | • Hydrocephalus |
| • Intracranial mass lesions | |
| • Chiari malformations, Dandy–Walker malformation | |
| • Metabolic or genetic syndromes (e.g., Crouzon, Apert) |