title: [Hydrocephalus Mimicking Idiopathic Normal Pressure Hydrocephalus as the First Manifestation of Neurosarcoidosis].
abstract: A 61-year-old woman presented with a 10-month history of gait disturbance and a 7-month history of urinary incontinence. The Hasegawa dementia scale-revised score indicated cognitive impairment. Brain magnetic resonance imaging (MRI) indicated hydrocephalus with disproportionately enlarged subarachnoid space. This is usually considered a characteristic finding in idiopathic normal pressure hydrocephalus (iNPH). Ventriculo-peritoneal shunting improved the patient's symptoms. Neurosarcoidosis was suspected as a cause of the hydrocephalus because of the abnormalities in the cerebrospinal fluid and the abnormal enhancement of the cauda equina, the leptomeninges of the brainstem, and the spinal cord, as seen on MRI with gadolinium enhancement. A biopsy from the mediastinum lymph nodes confirmed the histological diagnosis of sarcoidosis. Physicians should consider the possibility of neurosarcoidosis in patients presenting with hydrocephalus, even in cases where clinical and radiological data are characteristic of iNPH. (Received April 13, 2016; Accepted July 5, 2016; Published December 1, 2016).
authors.affiliation: Department of Neurology, Asahi General Hospital.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Sugiyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kumiko
authors.initials: K
authors.lastname: Agatsuma
authors.forename: Takeshi
authors.initials: T
authors.lastname: Bo
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shiojiri
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Mochida
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
mesh_terms: D001706:Biopsy; D002493:Central Nervous System Diseases / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology