Tuberculosis Presenting as Base of Skull Osteomyelitis with Stroke: A Case Report

This 70-year-old female patient, a housewife by occupation and a known case of diabetes mellitus on treatment with oral hypoglycaemic agents, presented with a 2-week history of occipital headache and unsteadiness on walking. She was on symptomatic treatment for the same with analgesics only. There was no associated nausea, vomiting or photophobia along with headache. The unsteadiness on walking was more to the right side with no associated slurring of speech. There was no history of fever, limb weakness or seizures. There was no history of evening rise of temperature, cough or weight loss. There was no past history of exposure to tuberculosis. Clinical examination demonstrated normal vital signs. Nervous system examination revealed normal cranial nerves and motor system. Cerebellar signs were positive with significant gait ataxia to the right side. Deep tendon reflexes were well elicited. No clinical signs of meningeal irritation were noted.