{
  "abstract": "A man in his 30s from South Asia presented with progressive neck pain, occipital headache and right-sided tongue deviation (occipital condyle syndrome). Initial imaging identified a destructive skull base lesion involving the right clivus, occipital condyle and C1 vertebra with compression of the hypoglossal nerve, raising concerns for malignancy. Concurrent necrotic mediastinal lymphadenopathy prompted endobronchial ultrasound-guided biopsy, which confirmed necrotising granulomatous lymphadenitis with Mycobacterium tuberculosis complex DNA. Quadruple antituberculous therapy and adjunctive corticosteroids gave significant clinical and radiological improvement at 6 months. This case highlights the importance of considering tuberculosis in the differential diagnosis of destructive skull base lesions even in non-endemic regions and in patients with previously negative TB screening.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medicine, Imperial College London, London, UK"
      ],
      "name": "Joshua J Hon"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "Vasundhara Singh"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "Gerda Reischer"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "Alistair Lawrence"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "Joe M Das"
    }
  ],
  "title": "Occipital condyle syndrome: a rare manifestation of skull base tuberculosis",
  "uid": "47d250bf-cc41-533b-bee0-42123355f732"
}