Cranial-epidural tuberculosis presenting as a scalp swelling.

Background: Unlike the brain tuberculoma, tubercular osteomyelitis of the skull is very rare and not sufficiently described in the literature. Awareness of this entity makes diagnosis possible.

Case Descriptions: Two unique cases of cranial and epidural tuberculosis (TB) with absence of intradural and brain involvement are presented. Both patients presented with scalp swellings but extending through the calvarium into the epidural space. Histologic/bacteriologic confirmation of tuberculosis was obtained from biopsy specimens. Magnetic resonance imaging (MRI) findings of this rare lesion are described for the first time.

Conclusions: Inflammatory scalp lesions with skull involvement and epidural extension should be investigated for tuberculous etiology. With early diagnosis and a combination of surgical and medical management, all cases of skull tuberculosis are potentially curable.