The diagnosis of extradural abscess as well as other forms of intracranial suppuration still remains a difficult problem. Frequently, too, after such a diagnosis is made the surgeon may fail to confirm it at the operating table, though it is later substantiated at autopsy. Occasionally such an abscess evacuates spontaneously by perforation through a diseased area in the skull or through a cranial suture and presents itself as an external fluctuant swelling in the neck or scalp. Such a fortunate outcome is, however, relatively rare.
In 1905 Auvert1 collected reports of nineteen such cases in which there were eight deaths, six recoveries and five questionable results. The condition occurred in thirteen adults, ten males and three females, and in one boy and one girl. In six of these cases, the abscess appeared as a swelling in the back of the neck; in six it was in the neighborhood