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J Neurol Neurosurg Psychiatry 2009;80:550-551 doi:10.1136/jnnp.2008.163725
  • Neurological picture

Sarcoidosis presenting with hydrocephalus

  1. M C Brouwer1,
  2. J de Gans1,
  3. R B Willemse2,
  4. D van de Beek1
  1. 1
    Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  2. 2
    Department of Neurosurgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  1. Dr M C Brouwer, Academic Medical Centre-Department of Neurology, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands; m.c.brouwer{at}amc.uva.nl
  • Accepted 20 November 2008

CASE REPORTS

Case No 1

A 33-year-old Afro-American man, born in Surinam, without a previous medical history, presented with a 3 week history of headache, nausea and walking difficulties. Neurological examination showed bradyphrenia and left-sided hemiparesis. Head MRI showed a focal dilated right lateral ventricle caused by a cystic lesion (fig 1A). CSF revealed a leucocyte count of 681/ml (87% lymphocytes) and a protein level of 1.04 g/l. CSF cultures and serological tests for Taenia solium, Treponema pallidum, Echinococcus and Borrelia burgdorferi species were negative; cultures and PCR were negative for Mycobacterium tuberculosis.

Figure 1

Case No 1. Axial (A) fluid attenuated inversion recovery weighed MRI shows focal cystic dilation of the occipital horn of the right lateral ventricle and transependymal CSF effusion. 18F-fluorodeoxyglucose positron emission tomography (B) shows enhancing lymph nodes …

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