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By E. Niedermeyer, F. da Silva

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2 Course The infection reaches the skull through its marrow and, for some unknown reasons, does not spread in this tissue but remains at the site of infection, involving the outer and inner tables. The process may be so invasive as to destroy both tables and produce a rugged edge whole in the skull. This process is not selflimited and in extreme cases may destroy galea, scalp, and dura and the brain may appear on the surface. 5 Diagnosis A thorough history, clinical evaluation, laboratory tests, culture, and radiologic tests help the diagnosis.

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