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Acquired encephalocele attributable to tuberculous osteitis: case report
1Department of Neurosurgery, Inkosi Albert Luthuli Central Hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, KwaZulu-Natal, South Africa. alex.vitali@excite.com
Neurosurgery
|May 23, 2008
Summary
Tuberculosis of the skull (calvarial tuberculosis) can lead to severe complications like large cranial defects and venous sinus thrombosis. This case highlights successful surgical and medical treatment for a child with an acquired encephalocele caused by extensive calvarial tuberculosis.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatric Surgery
Background:
- Calvarial tuberculosis is a rare but serious condition.
- It can manifest with diverse clinical presentations.
- Early diagnosis and treatment are crucial for favorable outcomes.
Observation:
- A 10-year-old boy presented with an infected encephalocele and signs of tuberculous mastoiditis.
- Imaging revealed an occipital encephalocele, mastoiditis, bone destruction, and sigmoid sinus occlusion.
- The cranial defect and venous sinus thrombosis were attributed to extensive calvarial tuberculosis.
Findings:
- Surgical excision of the encephalocele and mastoidectomy were performed.
- Despite negative cultures from the lesion, active tuberculosis in the mastoid confirmed the diagnosis.
- The patient received antituberculous therapy and showed clinical improvement.
Implications:
- This is the first reported case of calvarial tuberculosis causing a cranial defect, sigmoid sinus thrombosis, and an acquired encephalocele.
- Combined surgical and medical management proved curative.
- This case underscores the importance of considering tuberculosis in the differential diagnosis of cranial defects and venous sinus thrombosis in children.
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