Head injury. No mention of any lump or mass. No localized pain or tenderness.
X-Ray Skull Lateral View
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Pointed bony projection arising from external occipital protuberance. Outer table, diploic space and inner table clearly delineated beneath the projection.
Normal dimensions of sella turcica.
Paranasal sinuses clear.
An x-ray is conclusive to identify an occipital spur, and no further imaging is required.
Surgical excision may be postponed / avoided if the patient feels no discomfort, or can manage with topical analgesics, using soft pillows etc.
It is to be noted that any hard lump on the skull, be it painful or painless, tender or non-tender, should be put aside only after confirming that it is not part of a malignant process. In the present case, the outer table and diploic space of the underlying occipital bone are clearly intact. Thus, the patient is released with advices only.