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The lesions can be palpable on the skin and cause local pain and paraesthesia and, depending on the location, neurological deficits can also occur. This research aims to present an overview of typical imaging features as well as neurosurgical management. We examined the charts of patients who underwent surgery on a calvarial lesion in our department between 2004 and 2017 (\n                    <jats:italic>n<\/jats:italic>\n                    =133). Retrospectively, the pre-, intra-, and postoperative data were analyzed with morphological and histological findings and compared with each other. Pain, swelling, cosmetically disturbing, and neurological deficits were the main complaints. Seventy-seven lesions were limited to the bone, while another 56 lesions showed an infiltrating growth in the adjacent tissue. Depending on the clinical signs and suspected diagnosis, a biopsy, a partial removal, or a complete resection was performed. Histiocytosis (\n                    <jats:italic>n<\/jats:italic>\n                    =20), meningiomas (\n                    <jats:italic>n<\/jats:italic>\n                    =20), metastases (\n                    <jats:italic>n<\/jats:italic>\n                    =19), and osteomas (\n                    <jats:italic>n<\/jats:italic>\n                    =16) were the most common lesions. Fibrous dysplasia (\n                    <jats:italic>n<\/jats:italic>\n                    =6) and intraosseous hemangioma (\n                    <jats:italic>n<\/jats:italic>\n                    =9) were less common; other lesions were present only in isolated cases. Imaging features may suggest the lesion to be benign or malignant, but the diagnosis can be only confirmed by histological examination. The surgical strategy depends on the complaints, location of the lesion, and suspected diagnosis. Adjuvant treatment should be initiated according to the histological findings.\n                  <\/jats:p>","DOI":"10.1007\/s10143-021-01521-5","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T12:04:06Z","timestamp":1616414646000},"page":"3459-3469","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Calvarial lesions: overview of imaging features and neurosurgical management"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2226-4958","authenticated-orcid":false,"given":"Isabella","family":"Nasi-Kordhishti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann-Martin","family":"Hempel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian Heinrich","family":"Ebner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Tatagiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"1521_CR1","doi-asserted-by":"publisher","unstructured":"Afghani T, Mansoor H (2018) Types of orbital osteoma - a descriptive analysis. 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All procedures performed were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.Written consent was obtained from the patients in order to evaluate and publish the data anonymously","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}