6 month old female born with a skull defect in mid parietal region, with classic symptoms of engorgement and swelling aggravated by crying or dependent positioning. Clinical diagnosis of sinus pericranii (SP) was confirmed with imaging.

The patient was taken to surgery at approximately 1 year of age. During the procdure, a venous varix was identified in the subgaleal space and the auxiliary retromandibular draining venous limb was ligated and excised.  A small midline craniectomy was curetting out circumferentially around the base of the stalk of the SP. The stalk and pedicle were coagulated with bipolar cautery. There were no complications.