Subgaleal abscess with small epidural abscess

Case contributed by Dr Ian Bickle

Presentation

25-year-old diabetic. Occipital swelling. No erythema.

Patient Data

Age: 25 years
Gender: Male

Thick walled enhancing left occipital subgaleal collection with internal diffusion restriction.  This is contiguous a 1.5 cm defect in the inner and outer tables 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.

Case Discussion

An example of a large subgaleal collection with intracranial extension.  The inner and outer tables of the skull are both destroyed from the neighboring infective process.

The patient underwent incision and drainage confirming this diagnosis.

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