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April 1981

Combined Calvarial and CNS Sarcoidosis: Report of Two Cases

Author Affiliations

From the Pulmonary Diseases Section, Veterans Administration Medical Center (Dr Rohatgi), and the Malcolm Grow Medical Center (Dr Archutowska-Kempka), Washington, DC.

Arch Neurol. 1981;38(4):261-262. doi:10.1001/archneur.1981.00510040087019

In sarcoidosis, skeletal and CNS involvement occurs in 2% to 4% and 2% to 7% of the cases, respectively.1 Concurrent involvement of both systems is rare. We describe two patients with an unusual combination of calvarial and CNS sarcoidosis.

REPORT OF CASES  Case 1.—A 42-year-old woman had episodes of blurred vision and dysphasia. Physical examination results were unremarkable. Chest roentgenogram showed hilar adenopathy with diffuse reticulonodular infiltrate. Skull roentgenograms demonstrated several areas of lucency within the calvarium (Fig 1). An EEG showed theta slowing over the left frontotemporal region that was accentuated by hyperventilation. A brain scan demonstrated an area of increased uptake over the right hemisphere. Computed axial tomography showed an area of low density in the right frontal bone, with enlarged diploic space and erosion of the inner table. Gallium and bone scans showed multiple areas of increased radionuclide uptake over the calvarium (Fig 2).