An isolated fourth ventricle in neurosarcoidosis: MRI findings.
We report on an isolated enlargement of the fourth ventricle in a patient with neurosarcoidosis which developed 3 years after the insertion of a ventriculo-atrial shunt. Repeated MRI images were obtained in a patient with known neurosarcoidosis between 1995 and 2000. Imaging findings were correlated to the medical course of the patient, who developed a hydrocephalus and a trapped fourth ventricle consecutively. The isolation was presumably due to granulomatous inflammation of the ependyma surrounding the fourth ventricular outlets. The isolated fourth ventricle was responsible for a deterioration of neurological status. Neurosarcoidosis is a severe complication in sarcoidosis patients. An isolated enlargement of the fourth ventricle is a rare complication in clinically deteriorated patients with neurosarcoidosis and ventricular drainage, which may require neurosurgical treatment.
Hesselmann
Volker
V
Department of Radiology, University of Cologne, Joseph Stelzmann Strasse 9, 50924 Cologne, Germany. Volker.Hesselmann@uni-koeln.de
Wedekind
Christoph
C
Terstegge
Klaus
K
Schulte
Oliver
O
Voges
Juergen
J
Krug
Barbara
B
Lackner
Klaus
K
D000328:Adult; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000601:surgery; D002552:Cerebral Ventricles / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D012507:Sarcoidosis / Q000175:diagnosis* / Q000601:surgery; D017287:Ventriculoperitoneal Shunt