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Scalp and the Calvarium

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Tuberculosis of the Central Nervous System

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Abstract

Scalp and calvarial tuberculosis (TB) is infrequent even in endemic regions. While the former is rarely encountered even by dermatologists, the incidence of the latter may increase with increase in the incidence of TB and in number of patients with immunosuppressed states. The lack of awareness of this pathology, nonspecific imaging findings, and indolent history often result in delayed diagnosis. Painless scalp swelling with a discharging sinus is the commonest presentation of calvarial TB. Definitive diagnosis can be made either by demonstration of bacilli on staining, its growth on culture, characteristic granulomas on histology, or PCR tests. Early intervention is required to prevent intracranial extension. Anti-TB medications must be given for an extended period as it is a type of CNS TB. The role of surgery is in cases of diagnostic dilemma and where mass effect is a consideration.

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Abbreviations

AFB:

Acid-fast bacilli

CNS:

Central nervous system

CRP:

C-reactive protein

CT:

Computed tomography

DNA:

Deoxyribonucleic acid

ESR:

Erythrocyte sedimentation rate

FNAC:

Fine needle aspiration cytology

HIV:

Human immunodeficiency virus

IICP:

Increased intracranial pressure

MRI:

Magnetic resonance imaging

PCR:

Polymerase chain reaction

RIF:

Rifampicin

TB:

Tuberculosis

TBM:

Tubercular meningitis

References

  1. Daniel TM (2006) The history of tuberculosis. Respir Med 100:1862–1870

    Article  PubMed  Google Scholar 

  2. Tandon PN, Pande A (2012) Tuberculosis of the central nervous system. In: Tandon PN, Ramamurthy R (eds) Textbook of neurosurgery, 1st edn. Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, pp 725–741

    Google Scholar 

  3. Shimizu H (2007) Mycobacterial infections. In: Shimizu H (ed) Shimizu’s textbook of dermatology. Nakayama Shoten Publishers, Hokkaido, pp 484–488

    Google Scholar 

  4. Padmavathy L, Lakshmana Rao L, Pari T, Ethirajan N, Krishnaswamy B (2008) Lupus vulgaris and tuberculosis verrucosa cutis (TBVC) – a clinical, pathological and epidemiological study of 71 cases. Indian J Tuberc 55:203–209

    CAS  PubMed  Google Scholar 

  5. Aliağaoğlu C, Atasoy M, Güleç AI, Özdemir S, Erdem T, Engin RI (2009) Tuberculosis verrucosa cutis. Eur J Gen Med 6:268–273

    Google Scholar 

  6. Rajan J, Mathai AT, Prasad PVS, Kaviarasan PK (2011) Multifocal tuberculosis verrucosa cutis. Indian J Dermatol 56:332–334

    Article  PubMed  PubMed Central  Google Scholar 

  7. Khare P, Gupta R, Chand P, Agarwal S (2015) Calvarial tuberculosis presenting as cystic lesion: an unusual presentation in two patients. J Cytol 32:176–180

    Article  PubMed  PubMed Central  Google Scholar 

  8. Rajmohan BP, Anto D, Alappat JP (2004) Calvarial tuberculosis. Neurol India 52:278–279

    CAS  PubMed  Google Scholar 

  9. Nair AP, Mehrotra A, Das KK, Kumar B, Srivastav AK, Sahu RN, Kumar R (2015) Calvarial tuberculosis of the parietal bone: a rare complication after dental extraction. Asian J Neurosurg 10:219–221

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zaki S, Dadge D, Shanbag P (2010) Calvarial tuberculosis. Int J Infect Dis 14:e86–e87

    Article  PubMed  Google Scholar 

  11. Krishnan P, Sanyal S, Gupta D (2015) Primary lytic calvarial tuberculosis: a report of two cases. Acta Neurochir 157:2223–2225

    Article  PubMed  Google Scholar 

  12. Mukherjee KK, Kaushik R, Nada R, Khosla VK, Khandelwal N, Kak VK (2002) Calvarial tuberculosis. Surg Neurol 57:195–202

    Article  CAS  PubMed  Google Scholar 

  13. Diyora B, Kumar R, Modgi R, Sharma A (2009) Calvarial tuberculosis: a report of eleven patients. Neurol India 57:607–612

    Article  PubMed  Google Scholar 

  14. Ramdurg SR, Gupta DK, Suri A, Sharma BS, Mahapatra AK (2010) Calvarial tuberculosis: uncommon manifestation of common disease – a series of 21 cases. Br J Neurosurg 24:572–577

    Article  PubMed  Google Scholar 

  15. Jadhav RN, Palande DA (1999) Calvarial tuberculosis. Neurosurgery 45:1345–1349

    Article  CAS  PubMed  Google Scholar 

  16. Samson SK, Kulkarni V, Chacko AG (2002) An unusual presentation of calvarial tuberculosis. Postgrad Med J 78:184

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Sundaram PK, Sayed F (2007) Superior sagittal sinus thrombosis caused by calvarial tuberculosis: case report. Neurosurgery 60:E776

    Article  PubMed  Google Scholar 

  18. Raut AA, Nagar AM, Muzumdar D, Chawla AJ, Narlawar RS, Fattepurkar S, Bhatgadde VL (2004) Imaging features of calvarial tuberculosis: a study of 42 cases. AJNR Am J Neuroradiol 25:409–414

    PubMed  Google Scholar 

  19. Dawar P, Gupta DK, Sharma BS, Jyakumar A, Gamanagatti S (2013) Extensive calvarial tuberculosis presenting as exophytic ulcerated growth on scalp in an infant: an interesting case report with review of literature. Childs Nerv Syst 29:1215–1218

    Article  PubMed  Google Scholar 

  20. Rajesh A, Purohit AK, Lakshmi V (2009) Calvarial tubercular osteomyelitic abscess. Indian J Med Microbiol 27:380–381

    Article  CAS  PubMed  Google Scholar 

  21. Patankar T, Varma R, Krishnan A, Prasad S, Desai K, Castillo M (2000) Radiographic findings in tuberculosis of the calvarium. Neuroradiology 42:518–521

    Article  CAS  PubMed  Google Scholar 

  22. Dawar P, Satyarthee GD, Sharma BS (2015) Total resolution of large scalp swelling due to calvarial tuberculosis with medical management only: case report and review of the literature. Turk Neurosurg 25:313–316

    PubMed  Google Scholar 

  23. Rosli FJ, Haron R (2016) Tuberculosis of the skull mimicking a bony tumor. Asian J Neurosurg 11:68

    Article  PubMed  PubMed Central  Google Scholar 

  24. Stones DK, Schoeman CJ (2004) Calvarial tuberculosis. J Trop Pediatr 50:361–364

    Article  CAS  PubMed  Google Scholar 

  25. Strauss DC (1933) Tuberculosis of the flat bones of the vault of skull. Surg Gynaecol Obstet 57:384–398

    Google Scholar 

  26. Meng CM, Wu YK (1942) Tuberculosis of the flat bones of the vault of the skull. J Bone Joint Surg 34:341–353

    Google Scholar 

  27. Barton CJ (1961) Tuberculosis of the vault of skull. Br J Radiol 34:286–290

    Article  CAS  PubMed  Google Scholar 

  28. de Lima Fde M, Pessoa LA, da Silva JC, Jungman P, Maranhão S (2003) Calvarial tuberculosis: case report. Arq Neuropsiquiatr 61:144–145

    Article  PubMed  Google Scholar 

  29. García-García C, Ibarra V, Azcona-Gutiérrez JM, Oteo JA (2013) Calvarial tuberculosis with parenchymal involvement. Travel Med Infect Dis 11:329–331

    Article  PubMed  Google Scholar 

  30. Vitali AM (2008) Acquired encephalocele attributable to tuberculous osteitis: case report. Neurosurgery 62:E976

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, National Neurosciences Centre, Peerless Hospital Complex, IInd Floor, 360, Panchasayar, Garia, Kolkata, 700094, India

    Prasad Krishnan MD

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  1. Prasad Krishnan MD
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Correspondence to Prasad Krishnan MD .

Editor information

Editors and Affiliations

  1. Adnan Menderes University, School of Medicine, Aydın, Turkey

    Mehmet Turgut

  2. Mohammed V University in Rabat, Avicenne Military Hospital of Marrakech, Rabat, Morocco

    Ali Akhaddar

  3. Hacettepe University, School of Medicine, Ankara, Turkey

    Ahmet T. Turgut

  4. King George Medical University, Lucknow, Uttar Pradesh, India

    Ravindra K. Garg

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Krishnan, P. (2017). Scalp and the Calvarium. In: Turgut, M., Akhaddar, A., Turgut, A., Garg, R. (eds) Tuberculosis of the Central Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-319-50712-5_5

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  • DOI: https://doi.org/10.1007/978-3-319-50712-5_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-50711-8

  • Online ISBN: 978-3-319-50712-5

  • eBook Packages: MedicineMedicine (R0)

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