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Figure 6c.  Epidural abscess with sigmoid sinus phlebothrombosis in a 3-year-old girl with acute right mastoiditis but no neurologic symptoms. (a) Axial CT scan of the temporal bone shows increased attenuation of the right middle ear with a large osseous defect over the sigmoid sinus plate (arrow). (b) Axial contrast-enhanced CT scan shows a large epidural fluid collection (arrow) with some septa. Mastoidectomy with surgical drainage was performed, and intravenous antibiotic therapy was started. MR imaging was subsequently performed. (c-e) Axial T1-weighted (c) and T2-weighted (d) MR images and coronal MR venogram (e) show absence of flow (arrow) in the right sigmoid sinus.