Clinical Tip
Communicating Hydrocephalus in Wegener`s Granulomatosis
Katati MJ*, Ortiz I and dela Sabiocruz Sabido J
Servicio de Neurocirugía, Hospital Virgen de las nieves, Granada, Spain
*Corresponding author: Majed J Katati, Servicio de Neurocirugía, Hospital Virgen de las nieves, Granada, Spain
Published: 24 Jan, 2018
Cite this article as: Katati MJ, Ortiz I, dela Sabiocruz
Sabido J. Communicating
Hydrocephalus in Wegener`s
Granulomatosis. Clin Surg. 2018; 3:
1892.
Introduction
Wegener's granulomatosis (WG) is a systemic disease characterized by inflammatory changes of small and medium blood vessels were initially described by Wegener in 1936. The nervous system may be involved in up to 33% of cases [1], with the peripheral nervous system being most commonly affected so far less hydrocephalus [2].
Clinical Case
We describe an unusual case of a 53-year-old patient diagnosed with pulmonary biopsy of WG
disease with pulmonary involvement and sinusitis in 2013.
He was admitted to emergency for a sub-acute symptoms of disorientation, instability in the
last two months.
Cranial MRI demonstrated diffuse leptomeningeal thickening with increased tetra-ventricular
size.
The patient underwent lumbar puncture (LP) with an opening pressure of 21 mmHg, both
biochemistry and cultures CSF were normal’s.
CSF evacuation of 30 ml makes improvement of the patient`s symptoms, so a low-aperture
ventriculoperitoneal shunt (5/35 Gav®) was implanted.
Conclusion
Adult conical hydrocephalus should be included in the differential diagnosis in patients with WG produced by leptomeningeal thickness.
References
- Rangel-Castilla L, Barber SM, Zhang YJ. Hydrocephalus in Wegener's granulomatosis: neuroendoscopic findings and management. J Rheumatol. 2011;38(10):2277-8.
- Koga H, Oochi N, Osato S, Ishida I, Hirakata H, Okuda S, et al. Case report: Wegener's granulomatosis accompanied by communicating hydrocephalus. Am J Med Sci. 1994;307(4):278‐81.