NEUROSARCOID INFILTRATION OF THE VENTRICULAR CATHETER CAUSING SHUNT FAILURE - A CASE-REPORT

BACKGROUND Neurosarcoid is known to develop in 5% of patients with sar coidosis. A frequent manifestation of this condition is hydrocephalus, which will often require treatment with a ventricular shunt. METHODS Presented here is the case of a patient whose initial manifestation of neurosarcoidosis was hydrocephalus, and who then represented with mul tiple shunt failures. RESULTS On two revisions, the proximal catheter, after removal, was found to be occluded with noncaseating granulomato us material that had infiltrated the shunt lumen. CONCLUSIONS Although shunts may become occluded by inspissated proteinaceous or cellular d ebris, the occlusion of a shunt catheter by the ingrowth of the noncas eating granulomatous material of neurosarcoid has not been described b efore. This patient's course, the histopathologic findings, and neuros arcoidosis in general are discussed here. (C) 1997 by Elsevier Science Inc.