Sarcoidosis presenting as a posterior fossa mass

Whelan, Margaret; Stern, Jack

doi:10.1016/s0090-3019(81)80039-0

Cited by 19 publications

(6 citation statements)

References 17 publications

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“…1) Both obstructive and communicating hydrocephalus occur with neurosarcoidosis, and the main cause of hydrocephalus is granulomatous meningitis. 2,13) In the present case, the ventriculoperitoneal shunt was effective after the shunt operation. However, judging from the operative findings, both shunt malfunction occurred and the ventricular system Neurol Med Chir (Tokyo) 44, August, 2004 Isolated Third and Fourth Ventricles developed complicated and isolated compartments.…”

Section: Discussionsupporting

confidence: 48%

Isolated Third and Fourth Ventricles Associated With Neurosarcoidosis Successfully Treated by Neuroendoscopy-Case Report-

Hamada

Hayashi

Kurimoto

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 48-year-old woman presented with a unique case of isolated third and fourth ventricles associated with neurosarcoidosis, manifesting as upward gaze palsy. She had a past history of surgery for intracranial sarcoid granuloma 10 years previously and placement of a ventriculoperitoneal shunt 3 years later. Magnetic resonance imaging revealed isolated third and fourth ventricles. Endoscopic plasty of the right foramen of Monro, fenestration of the septum pellucidum, and revision of the ventriculoperitoneal shunt were performed. Postoperatively the size of the third and fourth ventricles was reduced, and the upward gaze palsy resolved. Endoscopic treatment is less invasive and effective for the treatment of multiple septum formation in the ventricular system.

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Section: Discussionsupporting

confidence: 48%

Isolated Third and Fourth Ventricles Associated With Neurosarcoidosis Successfully Treated by Neuroendoscopy-Case Report-

Hamada

Hayashi

Kurimoto

et al. 2004

Neurol. Med. Chir.(Tokyo)

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“…Cranial neuropathy is the most frequent manifestation but peripheral neuropathy, myopathy and parenchymatous disease of the CNS may also occur, singly or in combination. Most commonly granulomatous meningitis, either diffusely or as a more circumscribed process at the skull base, causes obstruction of outlet from the fourth ventricle (7)(8)(9)(10). Both communicating and obstructive forms have been described.…”

Section: Discussionmentioning

confidence: 99%

“…Both communicating and obstructive forms have been described. Most commonly granulomatous meningitis, either diffusely or as a more circumscribed process at the skull base, causes obstruction of outlet from the fourth ventricle (7)(8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Sarcoidosis with hydrocephalus: report of a case successfully treated with a ventriculo-peritoneal shunt and methylprednisolone pulse therapy

Lundh

Wikkelsø

1987

Acta Neurologica Scandinavica

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We describe a female patient with systemic sarcoidosis and hydrocephalus. She was initially satisfyingly treated with peroral steroids. When she later deteriorated, the treatment had to be changed due to side-effects. High dose intravenous methylprednisolone pulse therapy was tried with some, but insufficient, improvement. Therefore, a ventriculoperitoneal shunt operation was performed with immediate improvement. After that she was treated with intravenous methylprednisolone and her condition has remained proper and stable for 5 years. The possibility that pulse therapy might have contributed to the favourable course in our patient is discussed.

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“…Cerebrospinal fluid (CSF) pleocytosis often occur in the setting of other manifestations, such as cranial neuropathy, myelopathy, mass lesions, or other focal neurologic manifestations. Granulomata in the fourth ventricle could be responsible for hydrocephalus, which may require urgent treatment 6 .…”

Section: Hydrocephalus and Chronic Meningitismentioning

confidence: 99%

Neurosarcoidosis: guidance for the general neurologist

Dutra

Braga‐Neto

Oliveira

et al. 2012

Arq. Neuro-Psiquiatr.

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Sarcoidosis is an inflammatory multisystem disorder of unknown etiology with a worldwide distribution that can affect lungs, lymphatic system, skin, liver, eyes, and nervous system 1 . We owe the first recorded and illustrated description of sarcoidosis to Jonathan Hutchinson in 1878, when he reported a patient with a dermatologic disease, which comprised purplish, symmetric, and non-tender skin plaques, initially considered a manifestation of gout 2 . The term sarcoidosis comes from histological studies performed by Cesar Boeck, in 1899, who described pathological findings of skin lesions that resembled those of sarcoma, which he called 'sarkoid ' or 'sarcoma-like' 3 . Involvement of the nervous system was first recognized, in 1905, by Winkler, and, in 1909, Heerfordt described three patients in the context of facial nerve palsies, uveitis, parotid enlargement, and fever 1,3 . Neurosarcoidosis (NS) may involve any part of the nervous system with acute and chronic courses 1,4 . Cranial nerves, hypothalamus, and pituitary gland are the most commonly regions involved, but meninges, parenchyma, brainstem, and spinal cord may also be affected 4 . Clinical differentiation from other neurological diseases may be difficult when an isolated involvement of the nervous system is present 3,4 . In this review, we highlighted its clinical forms, pathogenesis, and treatment guidelines for NS, as guidance for general neurologists. neUROLOGiCaL ManiFesTaTiOns OF saRCOidOsisNeurologic manifestations are found in 5 to 20% of cases and symptoms may be mild or even severe, requiring a more aggressive intervention. About one-half of patients with NS can develop neurologic manifestations before systemic sarcoidosis is evident absTRaCT Neurosarcoidosis (NS) more commonly occurs in the setting of systemic disease. The diagnosis is based on a clinical history suggestive of NS, presence of noncaseating granulomas, and supportive evidence of sarcoid pathology, laboratory, and imaging studies. NS could involve any part of the nervous system and often demands high doses of steroids for symptom control. It presents low response to isolated steroids administration and frequently requires immunosuppressive agents. In NS, lymphocytes are polarized toward an excessive Th1 response, leading to overproduction of TNF-alpha and INF-gama, as well as lL-2 and IL-15. Infliximab, a chimeric monoclonal antibody that neutralizes the biological activity of TNF-alpha, is a new option in the NS treatment. We revised pathophysiology, clinical manifestations, diagnostic work up, and treatment of NS as guidance for the general neurologist.Key words: sarcoidosis, neurosarcoidosis, methotrexate, azathioprine, cyclophosphamide, infliximab. ResUMOA neurosarcoidose (NS) ocorre frequentemente no contexto de doença sistêmica. O diagnóstico é baseado na história clínica sugestiva de NS, presença de granulomas não-caseosos e achados anatomopatológicos, laboratoriais e radiológicos de sarcoidose. A NS causa manifestações neurológicas variadas, que apresentam, em ge...

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Sarcoidosis presenting as a posterior fossa mass

Cited by 19 publications

References 17 publications

Isolated Third and Fourth Ventricles Associated With Neurosarcoidosis Successfully Treated by Neuroendoscopy-Case Report-

Isolated Third and Fourth Ventricles Associated With Neurosarcoidosis Successfully Treated by Neuroendoscopy-Case Report-

Sarcoidosis with hydrocephalus: report of a case successfully treated with a ventriculo-peritoneal shunt and methylprednisolone pulse therapy

Neurosarcoidosis: guidance for the general neurologist

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