Posterior fossa subdural empyemas from mastoiditis

Discussion:

When there is a history of recurrent falls and trauma, hypodense collections could be mistaken for chronic subdural hematomas. However, the distribution is atypical for trauma and careful inspection for adjacent bone / sinus changes - as in this case - is important.

MRI is useful to confirm abnormal diffusion restriction in pyogenic collections, and also to demonstrate the extent of abnormal signal.

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