van Rooijen Johan M, Mijnhout Gerritje S, Aalders Tom T A, de Bondt R B J
Departments of Internal Medicine;
Neurosurgery;
Clin Pract. 2011 Sep 30;1(3):e66. doi: 10.4081/cp.2011.e66. eCollection 2011 Jul 1.
A 36-week-pregnant woman developed a symptomatic hydrocephalus. Chest imaging showed bihilar lymphadenopathy and histological examination of a mediastinal lymph node revealed non-caseating granulomas. After delivery, her neurologic complaints progressed. Placement of a ventriculoperitoneal drain (VPD) did not reduce the symptoms. However, steroids resulted in rapid disappearance of the hydrocephalus. Hydrocephalus is a very rare manifestation of sarcoidosis. The diagnosis relies on the ability of clinicians to recognize this disorder. This case shows how a difference in opinion of the several specialists involved can lead to a delay in diagnosis and treatment.
一名怀孕36周的妇女出现了有症状的脑积水。胸部影像学检查显示双侧肺门淋巴结肿大,纵隔淋巴结组织学检查发现非干酪样肉芽肿。分娩后,她的神经症状有所进展。放置脑室腹腔分流管(VPD)并未减轻症状。然而,使用类固醇后脑积水迅速消失。脑积水是结节病非常罕见的一种表现。诊断依赖于临床医生识别这种疾病的能力。该病例显示了参与其中的几位专家的意见分歧如何导致诊断和治疗的延迟。