Introduction: Brain abscess and subdural empyema are the most common surgically treated intracranial infections. Involvement of all layers from scalp, epidural and subdural region in brain abscess has not been reported. The clinical significance of the anatomy of emissary veins, sinuses and brain parenchyma is illustrated. Case presentation: A 25-year-old man with a history of sinusitis presented with headache, confusion, fever and a left frontal scalp swelling. Computed tomography (CT) scan of brain revealed sinusitis and abscesses involving scalp, epidural, subdural regions and brain parenchyma. The patient underwent surgical drainage and antibiotic treatment. No complication occurred and the patient recovered with no neurological deficit. Conclusion: Brain abscess is a potentially fatal complication of sinusitis. The presentation of scalp abscess could be a sign of deep infection. Clinicians should have a high degree of awareness in order to prevent neurological complications. Prompt diagnosis and treatment is emphasized.
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