Osteomyelitis of the Skull

• Two modes of spread

• Direct extension from paranasal sinuses

• Retrograde septic thrombophlebitis

• Epidural extension separates the dura from the inner table of skull

• Removes major blood supply to the inner table of skull

• Predisposes bone to widespread infection

• Sutures tend to arrest progress for some time

• Dura is resistant to infection at first

• Then yields to meningitis and abscess

• X-ray- findings become evident 7-10 days after infection starts

• Early

• Islands of normal bone

• Increased or diminished density

• Advanced

• Lytic process

• Frontal sinus is most commonly involved

• Brain abscess is most common complication