REVERSAL OF SYPHILITIC HYDROCEPHALUS WITH INTRAVENOUS PENICILLIN

Background: CSF shunting procedures are generally considered the funda mental therapy of syphilitic hydrocephalus. Methods: We followed up wi th CSF analysis and MR imaging a patient with progressive mental and g ait disturbances and tetraventricular hydrocephalus due to tertiary sy philis who was treated for 14 days with high dose intravenous penicill in alone. Results: Clinical and CSF abnormalities resolved within a fe w months, whereas the hydrocephalus disappeared only 30 months after t herapy. Conclusions: Before consideration of a CSF shunting procedure, a trial of high dose intravenous penicillin is warranted for patients with syphilitic hydrocephalus.