Setting Sun Sign, pathognomonic vs. Setting Sun Sign, developmental
Left picture: In this case there is no doubt about a pathognomonic setting sun sign. It may be observed, too, as a characteristic sign of increased intracranial pressure beyond the neonatal period and infancy. Right picture: In this case an intermittent setting sun sign is present which may be observed in neonates and young infants as a developmental phenomenon, disappearing thereafter, but which is not a sign of increased intracranial pressure.
In both neonates the sclera are visible above the iris of both eyes. Both neonates have a gastric tube because they have feeding problems. Left picture: A discrepancy is visible between the size of the facial skull and the neurocranium in favor of the latter; the abnormal position of the bulbi can be observed over a long time. Right picture: The observation of the abnormal position of the bulbi called ´setting sun sign´ is possible at times only for a short period because a rapid normalization occurs. Compare with the picture ad the bottom with normalization.