Lee Chang-Hyun, Jung Young Sub, Lee Sang Hyung
Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
J Korean Neurosurg Soc. 2010 Jul;48(1):79-81. doi: 10.3340/jkns.2010.48.1.79. Epub 2010 Jul 31.
We present a case of hydrocephalus as the primary manifestation of neurosarcoidosis. Sarcoidosis is a rare disease in Korea and its incidence is much lower than that of tuberculosis. Diagnosis is made by pathologic findings and by exclusion of other granulomatous disorders. Neurosarcoidosis is observed in approximately 5% of sarcoidosis. Its common manifestations are facial palsy (50% of patients with neurosarcoidosis) and optic neuritis. Hydrocephalus is a very uncommon reported finding. Although the typical presentation of sarcoidosis such as facial palsy is not a diagnostic dilemma, more atypical presentations such as hydrocephalus with altered mentality in a tuberculosis patient can lead to a misdiagnosis.
我们报告一例以脑积水为主要表现的神经结节病病例。结节病在韩国是一种罕见疾病，其发病率远低于结核病。诊断依据病理检查结果并排除其他肉芽肿性疾病。约5%的结节病患者会出现神经结节病。其常见表现为面神经麻痹（神经结节病患者中有50%出现此症状）和视神经炎。脑积水是一种报道较少见的表现。虽然结节病的典型表现如面神经麻痹不存在诊断难题，但像结核病患者出现脑积水伴精神状态改变这样更不典型的表现可能会导致误诊。
