Download PDF
CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2017; 06(01): 072-075
DOI: 10.1055/s-0036-1588032
Images in Neurosurgery
Thieme Medical and Scientific Publishers Private Ltd.

Tuberculosis of the Clivus

Vijay P. Joshi
1   Department of Neurosurgery, S P Institute of Neurosciences, Solapur, Maharashtra, India
,
Shirish Valsangkar
2   Department of Neurology, S P Institute of Neurosciences, Solapur, Maharashtra, India
,
Ashwin Valsangkar
2   Department of Neurology, S P Institute of Neurosciences, Solapur, Maharashtra, India
,
Anish Dekhne
3   Department of Pathology, S P Institute of Neurosciences, Solapur, Maharashtra, India
,
Satish Nivargi
4   Department of Anaesthesiology, S P Institute of Neurosciences, Solapur, Maharashtra, India
,
Amit Agrawal
5   Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
› Author Affiliations
Further Information

Publication History

16 May 2016

07 July 2016

Publication Date:
29 September 2016 (online)

   Permissions and Reprints

Abstract

The rarity of the tubercular involvement of the clivus makes the preoperative diagnosis difficult. We report a case of a 40-year-old man who presented with right-sided trigeminal neuralgia without any other neurological symptoms or deficits. Postcontrast images showed a dural-based lesion in the region of the clivus which was isointense on T1 images and hypointense on T2 images and the lesion was enhancing after contrast administration suggestive of a tumor. The patient underwent surgical excision of the lesion and the histopathological examination was suggestive of tuberculosis. The patient completed the course of antitubercular therapy and recovered well. Tuberculosis of the clivus region runs an indolent course and following appropriate treatment these patient do well.

Keywords

tuberculous osteitis - tuberculosis - clivus - skull base
 

  • References

  • 1 Mancusi G, Marks B, Czerny C. , et al. Tubercular osteomyelitis of the clivus and the nasopharynx. HNO 2005; 53 (12) 1081-1084
    CrossrefPubMedGoogle Scholar
  • 2 Richardus RA, Jansen JC, Steens SCA, Arend SM. Two immigrants with tuberculosis of the ear, nose, and throat region with skull base and cranial nerve involvement. Case Rep Med 2011; 2011: 675807
    PubMedGoogle Scholar
  • 3 Selvapandian S, Chandy MJ. Tuberculous granuloma of the clivus. Br J Neurosurg 1993; 7 (05) 581-582
    CrossrefPubMedGoogle Scholar
  • 4 Shenoy SN, Raja A. Tuberculous granuloma of the spheno-clival region. Neurol India 2004; 52 (01) 129-130
    PubMedGoogle Scholar
  • 5 Indira Devi B, Tyagi AK, Bhat DI, Santosh V. Tuberculous osteitis of clivus. Neurol India 2003; 51 (01) 69-70
    PubMedGoogle Scholar
  • 6 Strauss DC. Tuberculosis of the flat bones of the vault of the skull. Surg Gynecol Obstet 1933; 57: 384-398
    PubMedGoogle Scholar
  • 7 Tyagi AK, Kirollos RW, Kang NV. Tuberculous osteitis of the skull: a case report and review of the literature. Br J Neurosurg 1996; 10 (04) 399-401
    CrossrefPubMedGoogle Scholar
  • 8 Pancoast HK, Pendergrass EP, Schaeffer JP. The Head and Neck in Roentgen Diagnosis. Springfield, IL: Charles C. Thomas; 1942
    Google Scholar
  • 9 Sencer S, Sencer A, Aydin K, Hepgül K, Poyanli A, Minareci O. Imaging in tuberculosis of the skull and skull-base: case report. Neuroradiology 2003; 45 (03) 160-163
    CrossrefPubMedGoogle Scholar
  • 10 Diyora B, Kumar R, Modgi R, Sharma A. Calvarial tuberculosis: a report of eleven patients. Neurol India 2009; 57 (05) 607-612
    CrossrefPubMedGoogle Scholar
  • 11 Raut AA, Nagar AM, Muzumdar D. , et al. Imaging features of calvarial tuberculosis: a study of 42 cases. AJNR Am J Neuroradiol 2004; 25 (03) 409-414
    PubMedGoogle Scholar
  • 12 Ichikawa F, Tachibana S, Miyasaka Y. , et al. A case report of clival tuberculoma. CT Kenkyu 1987; 9 (01) 95-99
    PubMedGoogle Scholar
  • 13 Sethi A, Sabherwal A, Gulati A, Sareen D. Primary tuberculous petrositis. Acta Otolaryngol 2005; 125 (11) 1236-1239
    CrossrefPubMedGoogle Scholar
  • 14 Mongkolrattanothai K, Oram R, Redleaf M, Bova J, Englund JA. Tuberculous otitis media with mastoiditis and central nervous system involvement. Pediatr Infect Dis J 2003; 22 (05) 453-456
    PubMedGoogle Scholar
  • 15 Dutta P, Bhansali A, Singh P, Bhat MH. Suprasellar tubercular abscess presenting as panhypopituitarism: a common lesion in an uncommon site with a brief review of literature. Pituitary 2006; 9 (01) 73-77
    CrossrefPubMedGoogle Scholar