Subgaleal abscess with small epidural abscess
25-year-old diabetic. Occipital swelling. No erythema.
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Thick walled enhancing left occipital subgaleal collection with internal diffusion restriction. This is contiguous a 1.5cm defect in the inner and outer table of the skull.
The underlying dura is thickened and enhancing with a small epidural collection best seen on sagittal post contrast T1 as a slit of non-enhancement.
The remainder of the intracranial appearances is normal.
An example of a large subgaleal collection with intracranial extension. The inner and outer tables of the skull both destroyed from the neighbouring infective process.
The patient underwent incision and drainage confirming this diagnosis.