Reversal of syphilitic hydrocephalus with intravenous penicillin.
BACKGROUND
CSF shunting procedures are generally considered the fundamental therapy of syphilitic hydrocephalus.


METHODS
We followed up with CSF analysis and MR imaging a patient with progressive mental and gait disturbances and tetraventricular hydrocephalus due to tertiary syphilis who was treated for 14 days with high dose intravenous penicillin alone.


RESULTS
Clinical and CSF abnormalities resolved within a few months, whereas the hydrocephalus disappeared only 30 months after therapy.


CONCLUSIONS
Before consideration of a CSF shunting procedure, a trial of high dose intravenous penicillin is warranted for patients with syphilitic hydrocephalus.
Cosottini
M
M
Clinica Neurologica II, Università di Firenze, Florence, Italy.
Mascalchi
M
M
Zaccara
G
G
Arnetoli
G
G
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000209:etiology*; D007262:Infusions, Intravenous; D007769:Lactams; D008279:Magnetic Resonance Imaging; D008297:Male; D009494:Neurosyphilis / Q000134:cerebrospinal fluid / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D007769:Lactams; D010406:Penicillins