Tuberculosis primarily affecting the calvarium is one of the rare diseases which is on the rise in the past few decades. This disease has been rarely reported in the literature even from endemic regions. We report seven patients diagnosed with calvarial tuberculosis. All cases had histological features of tuberculosis and were mantoux positive. All were negative for AFB smears. Two out of four cases tested for TB GeneXpert were positive. The clinical presentations, radiological features and the management of the cases are discussed. Early diagnosis with high index of suspicion and awareness about the features of calvarial tuberculosis would help in proper management of the condition.

Introduction: Endoscopic method is an alternative to shunt placement and open surgery; it creates a communication between cyst, ventricular system and subarachnoid system. Aim: To describe the demographic, clinical profile, operative technique, complications and outcome following endoscopic management of intracranial arachnoid cysts at a tertiary Care Hospital in Southern India. Materials and Methods: A retrospective observational study was conducted in tertiary care hospital in southern India in which case records of all 42 symptomatic patients diagnosed with intracranial arachnoid cyst and who underwent surgical management by endoscopic techniques from 1995 to 2010 were included. Demographics, clinical presentations, type of surgery, complications and clinical outcome were recorded and results were expressed in terms of frequency and percentages. Results: Study included 30 males and 12 females with a mean (SD) age of 14.8 (15.5) years. The most common presenting feature was raised intracranial pressure (27.6%). Cysts were commonly located inposteriorfossa(35.7%)followedbyintraventricularregion(31.0%). All patients (100%) underwent endoscopic fenestration with either cystoventriculostomy or cystocisternostomy. Endoscopic Third Ventriculostomy (ETV) was done in 21.4% of patients associated with hydrocephalus. Postoperative complications (11.9%) included Cerebrospinal Fluid (CSF) leak, subdural hygroma and metabolic complications. Mortality rate was 2.4%. Follow-up period ranged between one month to 99 months (median 24 months). Success rate of the procedure was 95%. Conclusion: Prevalence of intracranial arachnoid cyst is common in males and is often located in the posterior fossa. The endoscopic management of intracranial arachnoid cyst is safe and is associated with superior clinical outcome

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