1. Forty cases of tuberculosis of the skull have been analyzed and the chinicopathological aspects of the disease discussed.
2. Tuberculosis of the skull is not rare in parts of the world where tuberculosis is prevalent. It is an affection predominantly of childhood and adolescence.
3. Tuberculosis of the skull is practically always secondary to an active or latent tuberculous lesion elsewhere in the body. it is frequently associated with pulmonary lesions and those of bones and joints. Not infrequently tuberculosis of other flat bones may coexist in the same individual.
4. The lesion usually is of the circumscribed type often represented clinically by a painless cold abscess or discharging sinus.
5. A correct diagnosis usually can be made if this condition is kept in mind, particularly if tuberculous lesions are found in other parts of the body. Occasionally, however, difficulty is encountered in differentiating tuberculosis from other destructive lesions, notably syphilis. Laboratory examinations following aspiration or biopsy have proved of much value and should be employed whenever possible.
6. Roentgenographic examination is helpful, but is not always reliable, and at times may be quite misleading.
7. A cure can be reasonably hoped for in selected cases, if local excision is carried out, but in the majority of cases the condition is so far advanced that treatment consists of simple local dressings. In a few cases high-voltage roentgen therapy has proved beneficial.
8. Whatever the local treatment may be, the fact should be appreciated, that patients with a tuberculous lesion of the skull are suffering from a tuberculous disease and, for this reason, require adequate general antituberculosis care.
(C) 1942 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.