Medscape is available in 5 Language Editions – Choose your Edition here.


Cutaneous Ectopic Brain

  • Author: Camila K Janniger, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Jun 24, 2016


Extracranial brain tissue without a direct connection to the brain itself may be an isolated cutaneous embryonic defect, usually on occipital or parietal areas of the scalp. It is also known as heterotopic brain tissue or cutaneous ectopic brain (CEB).

Lee and Mclaurin[1] described CEB in 1955 in a 1-year-old girl with a flat, almost perfectly circular, bluish-red plaque approximately 3 cm in diameter on the posterior midline of her scalp. Microscopically, heterotopic glial tissue in a pattern suggestive of abortive gyri and sulci was evident within the dermis. Additional patients with CEB have since been described.

Heterotopic brain tissue is a rare developmental abnormality that usually has no effect on neurological development.



CEB may be an isolated embryonic rest or a congenital herniation through the skull with an eventual loss of connection. Perhaps the neural tube initially overgrows, preventing closure of the cranial or spinal coverings. Thus, its pathogenesis is uncertain.



Many congenital cutaneous disorders of the scalp have been described, all of which are quite uncommon. CEB is less common than encephalocele.



The prognosis for patients with cutaneous ectopic brain (CEB) generally is good because no communication exists with underlying structures and few, if any, serious associated anomalies occur.

Contributor Information and Disclosures

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Albert C Yan, MD Section Chief, Associate Professor, Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine

Albert C Yan, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology, Society for Pediatric Dermatology, American Academy of Pediatrics

Disclosure: Nothing to disclose.

  1. Lee CM Jr, Mclaurin RL. Heterotopic brain tissue as an isolated embryonic rest. J Neurosurg. 1955 Mar. 12(2):190-5. [Medline].

  2. Rogers GF, Mulliken JB, Kozakewich HP. Heterotopic neural nodules of the scalp. Plast Reconstr Surg. 2005 Feb. 115(2):376-82. [Medline].

  3. Stevens CA, Galen W. The hair collar sign. Am J Med Genet A. 2008 Feb 15. 146(4):484-7. [Medline].

  4. Kurban Y, Sahin I, Uyar I, Deveci S, Gul D. Heterotopic brain tissue on the face and neck in a neonate: a rare case report and literature review. J Matern Fetal Neonatal Med. 2013 Apr. 26(6):619-21. [Medline].

  5. Ghose S, Balasubramaniam ST, Mahindrakar A, Sharma V, Sen S, Sarkar C, et al. Orbital ectopic glial tissue in relation to medial rectus: a rare entity. Clin Experiment Ophthalmol. 2005 Feb. 33(1):67-9. [Medline].

  6. Meyer P, Arnold Wörner N, Goldblum D, Bruder E. [Heterotopic glioneuronal brain tissue in the orbit: case report]. Klin Monbl Augenheilkd. 2013 Aug. 230(8):829-31. [Medline].

  7. Giannas JE, Bayat A, Davenport PJ. Heterotopic nasopharyngeal brain tissue associated with cleft palate. Br J Plast Surg. 2005 Sep. 58(6):862-4. [Medline].

  8. Grover AK, Chaudhuri Z, Popli J. Clinical anophthalmia with orbital heterotopic brain tissue. Ophthalmic Surg Lasers Imaging. 2007 Mar-Apr. 38(2):148-50. [Medline].

  9. Commens C, Rogers M, Kan A. Heterotropic brain tissue presenting as bald cysts with a collar of hypertrophic hair. The 'hair collar' sign. Arch Dermatol. 1989 Sep. 125(9):1253-6. [Medline].

  10. Drolet BA, Clowry L Jr, McTigue MK, Esterly NB. The hair collar sign: marker for cranial dysraphism. Pediatrics. 1995 Aug. 96(2 Pt 1):309-13. [Medline].

  11. Ramos L, Coutinho I, Cardoso JC, Garcia H, Cordeiro MR. Frontal cutaneous meningioma - Case report. An Bras Dermatol. 2015 Jun. 90 (3 Suppl 1):130-3. [Medline].

  12. Avecillas-Chasin JM, Saceda-Gutierrez J, Alonso-Lera P, Garcia-Pumarino R, Issa S, López E, et al. Scalp Metastases of Recurrent Meningiomas: Aggressive Behavior or Surgical Seeding?. World Neurosurg. 2015 Jul. 84 (1):121-31. [Medline].

  13. Held I, Rose C, Hamm H, Folster-Holst R. The hair collar sign - a possible indication of cranial dysraphism. J Dtsch Dermatol Ges. 2011 Feb. 9(2):136-8. [Medline].

  14. Ma C, Li X, Li Y, Qu X. Primary Ectopic Meningioma of the Tongue: Case Report and Review of the Literature. J Oral Maxillofac Surg. 2016 May 2. [Medline].

  15. Altissimi G, Ascani S, Falcetti S, Cazzato C, Bravi I. Central nervous system tissue heterotopia of the nose: case report and review of the literature. Acta Otorhinolaryngol Ital. 2009 Aug. 29(4):218-21. [Medline]. [Full Text].

  16. Ali MJ, Kamal S, Vemuganti GK, Naik MN. Glial Heterotopia or Ectopic Brain Masquerading as a Dacyrocystocele. Ophthal Plast Reconstr Surg. 2014 Jan 31. [Medline].

  17. Modarresifar H, Ho L. Brain heterotopia. Clin Nucl Med. 2009 Mar. 34(3):151-2. [Medline].

  18. Battistella M, Guedj N, Fallet-Bianco C, Bodemer C, Brousse N, Fraitag S. The histopathological spectrum of cutaneous meningeal heterotopias: clues and pitfalls. Histopathology. 2011 Sep. 59(3):407-20. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.