Scalp Abscess Developing Dura Mater Extension in a Newborn Infant : A Case Eeport / 대한주산의학회잡지

The risk factors associated with neonatal scalp abscess include electrode insertion for fetal scalp monitoring, traumatic scalp lacerations, and sepsis or meningitis. We report a case of neonatal scalp abscess with extension to dura mater, although our patient had no known risk factors. A 18-day-old, full-term baby was referred to the our hospital to evaluate a swelling over his left occipital scalp. A full sepsis work-up was performed and all were negative. Cranial sonography revealed echogenic cystic mass with peripheral vascularity consistent with ruptured epidermoid cyst or scalp abscess. The computed tomography (CT) scan of head was performed because of possibility of ruptured epidermoid cyt and revealed 2.0x2.0 cm sized hyperattenuating mass with suspicious intracranial extension. The magnetic resonance imaging (MRI) of head revealed the presence of 1.4x1.1 cm sized peripheral rim enhancing mass at left occipital area consistent with scalp abscess. And also, the lesion was suspicious dural exposure at left temporal area. Clinicians should be aware that scalp abscess may occur without any risk factors and perform diagnostic workup including a complete sepsis evaluation, cerebrospinal fluid analysis (CSF), and cranial imaging study to screen for intracranial extension.

A Case of Intracranial Dermoid Cyst Associated with Scalp Abscess / 대한소아신경학회지

Intracranial dermoid cyst is a rare congenital disease originating in the embryo. Intracranial dermoid cysts are usually detected before five years of age; however, asymptomatic cysts have been discovered after the third decade of life through various complications. Sometimes, there are neurologic symptoms caused by a cystic mass effect and if there is a dermoid sinus, purulent infections can occur. Early diagnosis is important and as such, CT or MR imaging for recognition of the location, size, and characteristics of the cysts are recommended before surgical resection. Extradural dermoid cysts with an intact occipital dermoid sinus are a rare event. We report a case of intracranial dermoid cyst associated with scalp abscess. In this case, a three-year-old boy was presented with scalp abscess and we performed MR imaging, which revealed a cystic region. The prognosis after resection operation was good without any complication.

Parietal Epidural Dermoid Mimicking a Scalp Abscess in an Infant: Case Report.

Scalp masses that involve the scalp or the cranium especially over the parietal bone are uncommon presentation in infants. We report a case of an 8-week old female child who presented with a left parietal scalp mass which had been progressively increasing since birth. CT scan revealed the mass extending into the cranium with underlying bone defect over the parietal area, with medial extension till the sagittal suture. Intraoperatively there was presence of thick white infected flaky material with small tufts of hair which was removed completely till the bone edges and from the epidural space. There was no recurrence postoperatively and the baby was discharged after a week of antibiotics. This case provides an example that simple looking scalp masses in infants and children should be managed with caution to prevent further morbidity.