Calvarial tuberculosis.
OBJECTIVE: Tuberculosis is endemic in developing countries. However, calvarial tuberculosis is rare and only a few cases have been reported. In a review of the literature, we found only six cases of calvarial tuberculosis reported with computed tomographic findings. We report a series of seven patients with calvarial tuberculosis, and we discuss their presentations and treatments. METHODS: The patients were studied with respect to age and sex prevalences, previous histories of trauma and tuberculosis, and presenting complaints. Plain cranial x-ray films and computed tomographic scans were used for diagnoses. All patients underwent surgery and antituberculous chemotherapy. RESULTS: Of the presenting patients, 71.42% were less than 20 years of age. There was a female predominance, with a male/female ratio of 1:6. Painless swelling and discharging sinuses over the scalp were the most common presenting features. One patient presented with osteomyelitis and sinus formation, with associated meningitis. All patients recovered well after surgery and antituberculous chemotherapy, except for one patient who discontinued drug treatment. CONCLUSION: Although calvarial tuberculosis is rare, the possibility of this disease should be considered when patients report previous histories of tuberculosis or are from areas in which the disease is endemic. Surgery is indicated in cases with associated neurological deficits or sinus formation. Antituberculous therapy should be continued for 18 months.