The purpose of this paper is to call attention to the high incidence of intracranial infection (meningitis, cerebral abscess) when a complete occipital dermal sinus is associated with a dermoid cyst. In addition, important clinical and radiological findings are stressed that should make one suspicious when this condition is present. The congenital dermal sinus represents a midline defect whereby the dermal sinus opening in the skin is connected by a tract to a dermoid cyst in the posterior fossa. This pathway is a direct source of intracranial infection. The sinus tract extending through the occipital bone causes a bony defect which can be diagnosed radiologically. These radiological findings were mentioned by Matson and Ingraham2 in 1951 and later clarified by Logue and Till3 in 1952. During the past 10 years 17 cases have been published (Table 1), to which we are adding two additional cases.
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