A subcutaneous bursa overlying the external occipital protuberance (inion), developing from repetitive pressure between the skull and headwear, pillows, or helmets. It presents as a soft, non-tender fluctuant swelling at the back of the skull.
Occipital subcutaneous bursitis is common in individuals who wear helmets for prolonged periods (cyclists, construction workers) or use hard pillows. It must be distinguished from lipoma, sebaceous cyst, and posterior fossa skull lesions by its soft fluctuant consistency and superficial location. Aspiration and padding are usually curative. Infected bursae require incision and drainage.
Pressure bursitis over the external occipital protuberance from repeated helmet contact, producing a painless fluctuant occipital swelling managed by padding modification and aspiration.
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