Rare Diseases Symptoms Automatic Extraction
Home
A random Abstract
Our Project
Our Team
Obstructive hydrocephalus and progressive psychosis: rare presentations of neurosarcoidosis.
[hydrocephalus with stenosis of the aqueduct of sylvius]
Neurosarcoidosis
presents
with
meningitis
,
cranial
nerve
involvement
,
and
parenchymal
masses
.
Usually
,
abnormal
MR
enhancement
and
/
or
structural
lesion
(
s
)
are
present
.
Communicating
hydrocephalus
arises
from
meningeal
arachnoid
granulation
involvement
.
Reported
cases
of
obstructive
hydrocephalus
have
all
involved
obstructing
ventricular
lesions
.
A
40
-
year
-old
African
American
man
presented
with
papilledema
,
diplopia
,
and
headache
.
Magnetic
resonance
imaging
revealed
"
aqueductal
stenosis
"
without
abnormal
enhancement
or
obstructive
lesion
.
Although
symptoms
resolved
with
shunting
,
he
soon
developed
progressive
psychotic
symptoms
.
Serial
MR
scans
remained
free
of
abnormal
enhancement
or
structural
mass
lesion
(
s
)
but
revealed
long
repetition
time
and
proton
density
signal
changes
within
the
medial
temporal
lobe
structures
and
deep
white
matter
that
remained
stable
over
8
months
despite
clinical
progression
.
Serial
CSF
studies
were
nondiagnostic
.
Open
temporal
lobe
brain
and
meningeal
biopsy
revealed
noncaseating
granulomas
within
the
parenchyma
and
meninges
consistent
with
sarcoid
.
Total
-body
computed
tomography
scans
ruled
out
systemic
sarcoid
.
The
patient
steadily
improved
on
steroid
therapy
.
Neurosarcoid
psychiatric
symptoms
are
usually
associated
with
diffuse
meningeal
enhancement
from
meningitis
.
Our
case
reveals
that
absence
of
abnormal
enhancement
or
structural
mass
lesion
on
MR
and
normal
CSF
ACE
levels
do
not
rule
out
neurosarcoid
.
Based
on
a
patent
cerebral
aqueduct
and
the
T
2
MR
and
pathology
findings
,
we
postulate
that
altered
brain
tissue
compliance
with
impairment
of
normal
pulsatile
augmentation
of
aqueduct
CSF
flow
was
the
likely
cause
of
obstructive
hydrocephalus
.
This
represents
a
very
rare
psychiatric
presentation
and
reports
a
new
potential
mechanism
for
the
development
of
hydrocephalus
with
neurosarcoid
.
Diseases
Validation
Diseases presenting
"communicating hydrocephalus"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
This symptom has already been validated