• World Neurosurg · Feb 2017

    Case Reports

    Neglected Recurrent Scalp sinus: Calvarial Tuberculosis with Intracrnial and Extracranial Extension.

    • Krishnamurthy B Holeppagol, Biswaranjan N Nayak, Ram Kumar K Goyal, Arunkumar K Kumar, Prafulla K Sahoo, and Debabrat Biswal.
    • Department of Neurosurgery, Apollo Hospitals, Bhubaneswar, Odisha, India. Electronic address: drkrishnabhk.km@gmail.com.
    • World Neurosurg. 2017 Feb 1; 98: 879.e5-879.e7.

    BackgroundCalvarial tuberculosis (TB) with intracranial tuberculoma and skin involvement is rare condition even in endemic regions.Case PresentationA 43-year-old man presented with a generalized seizure, altered mental state, scalp swelling, and pus-discharging sinus over the scalp. Magnetic resonance imaging of the brain indicated a conflicting diagnosis of anaplastic meningiomas and chronic osteomyelitis with intracranial extension. Débridement and drainage of intracranial pus was performed. Histopathologic examination revealed TB. After surgery, the patient's general condition improved, and he was started on antitubercular drugs.ConclusionsCalvarial TB manifests with various clinical features, and strong clinical suspicion is needed to diagnose and treat it. Only a few cases of calvarial TB with either skin involvement or intracranial extension have been reported in the literature. The present case was challenging to diagnose with a rare presentation involving both intracranial and extracranial extension.Copyright © 2016 Elsevier Inc. All rights reserved.

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