PMC8720419_01
Computed tomography of the head showing in a (small arrow) left extra-axial parietooccipital focal hypoattenuation and in b (green circle) adjacent bone erosion.
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F1
Computerized tomography of the head [Figure 1] showed left extra-axial parietooccipital focal hypoattenuation with adjacent bone erosion.
Brain magnetic resonance imaging sequences. In a (green circle), T2 weighted. In b (red circle), fluid attenuation imaging recovery acquisition (FLAIR). In c (yellow circle), diffusion-weighted sequence (DWI). In d (blue circle), gadolinium-enhanced T1 acquisition. One can see left parietooccipital subdural collection well demarked with hypersignal in T2 and intermediate signal in T2/FLAIR with water restriction to diffusion in DWI and peripheral enhancement after contrast.
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F2
Brain MRI [Figure 2] reported left parietooccipital subdural collection associated with focal leptomeningeal thickening.
Left parietooccipital dura mater biopsy. In a, noncaseous granuloma with multinucleated giant cells. In b, silver stain showing rounded birefringent structures consistent with paracoccidioidomycosis (circle).
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F3
The adjacent dura mater was resected showing noncaseous granuloma with multinucleated giant cells and asteroids bodies on histopathology [Figure 3].