title: Swelling on the head--a forgotten lesson: a case report of an intradiploic epidermal cyst with an iatrogenic complication.
abstract: Swellings on the head are common, but all require appropriate investigation and caution must be exercised during surgical intervention. We report a patient in whom an attempt at biopsy of a swelling in the scalp was made without any radiological imaging and led to an intracranial complication that caused a neurological deficit. The lesion was an intradiploic epidermal cyst. Though appropriate precautions are usually taken, lessons previously learnt are sometimes forgotten. We would therefore like to remind readers that swellings of the scalp that seem to be attached to the skull on clinical examination should be investigated by radiographs and preferably by computed tomography before surgical intervention because of the possibility of intracranial extension.
authors.affiliation: Department of Neurosurgery, University Hospital of Wales, Cardiff CF14 4XW, Wales, UK. sudhakar1@ntlworld.com
authors.forename: N
authors.initials: N
authors.lastname: Sudhakar
authors.forename: G C
authors.initials: GC
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D001707:Biopsy, Needle / Q000009:adverse effects*; D001847:Bone Diseases / Q000473:pathology; D004814:Epidermal Cyst / Q000473:pathology*; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007049:Iatrogenic Disease; D011859:Radiography; D013701:Temporal Bone / Q000473:pathology*