Post-traumatic extensive chronic osteomyelitis of skull vault: An illustrative case report

  • Maksalmina Reshtin
  • Ahmad Faeez
  • Haseeb Mehmood Qadri Post Graduate Resident, Punjab Institute of Neurosciences, Lahore
  • Abdul Ghafoor
  • Ahtesham Khizar
Keywords: Osteomyelitis, Traumatic brain injuries, Cranioplasty, Craniotomy, Skull

Abstract

Chronic osteomyelitis of the skull base is a commonly reported pathology in existing scientific literature, but chronic osteomyelitis of the skull vault (COSV) is a rarely documented disease. We report the case of a 38 years old Afghan male with a presenting complaint of irregular swelling on the skull vault for six months. The patient had a history of head trauma one year back with a compound depressed fracture which had been surgically managed then. Physical examination revealed a 15 x 15 cm hard, immobile swelling with an old scar mark over the scalp. Neuroimaging was consistent with diffuse, bilateral frontoparietal swelling of bony origin, sparing underlying brain parenchyma. Surgically excision of the lesion was done through a bicoronal skin flap and cranioplasty done at the same time. Histological findings of the specimen reported chronic osteomyelitis. However, microbiology revealed no growth in culture. Patient was discharged on the second postoperative day uneventfully. This case turns minds into keeping skull vault osteomyelitis as differential diagnosis besides other spontaneous bony lesions; e.g. fibrous dysplasia, osteoma and giant cell tumours.

Abbreviations:
COSV: Chronic osteomyelitis of skull vault, CT: Computed Tomography, MRI: Magnetic Resonance Imaging,
PMMA: Polymethylmethacrylate, SBO: Skull Base Osteomyelitis.

doi: https://doi.org/10.12669/pjms.40.12(PINS).10977

How to cite this: Reshtin M, Faeez A, Qadri HM, Ghafoor A, Khizar A. Post-traumatic extensive chronic osteomyelitis of skull vault: An illustrative case report. Pak J Med Sci. 2024;40(12):S75-S79. doi: https://doi.org/10.12669/pjms.40.12(PINS).10977

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2024-11-27
How to Cite
Reshtin, M., Faeez, A., Qadri, H. M., Ghafoor, A., & Khizar, A. (2024). Post-traumatic extensive chronic osteomyelitis of skull vault: An illustrative case report. Pakistan Journal of Medical Sciences, 40(12(PINS), S75-S79. https://doi.org/10.12669/pjms.40.12(PINS).10977

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