Pott’s puffy tumor is described as an osteomyelitis of the frontal bone with associated subperiosteal abscess. It usually presents as a swelling over the forehead. Despite its decreased incidence in the postantibiotic era, intracranial complications can be seen in upto 40% of cases. Rupture resulting in a draining cutaneous fistula has also been reported. We present one such case of a patient with two paramedian scalp masses that were initially ignored. Rupture of one of the masses led to a discharging sinus in an atypical location behind the coronal suture.The subsequent development of hemiparesis brought the patient to emergency. The location and clinical presentation led us to initially suspect an epidermoid/dermoid pathology until the final radiological and histological correlation. A bifrontal craniectomy with ultrasound guided aspiration of the abscess led to improved outcomes.

Keywords: Puffy Tumor; EpiduralCutaneous Fistula.