Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_188»
«MEDICAL WRITING: CASE ABSTRACT_188»
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panventricular enlargement as the primary manifestation of neurosarcoidosis: a
Hydrocephalus is very uncommon in
neurosarcoidosis. To date, there have been only five reported cases of
hydrocephalus occurring as the first manifestation of neurosarcoidosis. Such a
presentation in a previously healthy patient is challenging to diagnose.
A 31-year-old Japanese man who had
no relevant past history other than sinusitis was admitted to our institution
complaining of low-grade fever and mild headache. He was alert and
neurologically intact. No respiratory symptoms were observed. Laboratory
examination revealed mild elevation of erythrocyte sedimentation rate and serum
CD4/CD8 ratio. Serum angiotensin-converting enzyme level was in the normal
range. His cerebrospinal fluid showed mild pleocytosis and increased protein
level. A chest X-ray revealed bihilar lymphadenopathy with normal lung
parenchyma. Computed tomography of his head showed remarkable hydrocephalus
with dilatation of all ventricles, particularly the fourth. Gadolinium-enhanced
magnetic resonance imaging demonstrated leptomeningeal millet seed-like
enhancement and multiple small enhancing lesions along the Virchow–Robin
spaces. These findings strongly suggested a chronic inflammatory disease such
as neurosarcoidosis. To treat the hydrocephalus, a ventriculoperitoneal shunt
was inserted. The postoperative course was satisfactory. After surgery, nasal
and skin biopsies were performed and pathological analysis revealed non-caseating
granulomas consistent with sarcoidosis. The findings of gallium scintigraphy
also supported the diagnosis of sarcoidosis. We obtained the definitive
diagnosis of sarcoidosis 3 weeks after admission from the pathological findings
by the nasal and skin biopsies, and corticosteroid therapy was started after
We present a rare case of
neurosarcoidosis manifesting as acute hydrocephalus with dilatation of all
ventricles, particularly the fourth. As hydrocephalus due to neurosarcoidosis
has high morbidity and mortality, early diagnosis and proper treatment are
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