Communicating hydrocephalus as a complication of isolated CNS angiitis--a case report

A sixty-six-year-old man presented with headache, left hemiparesis, right crural monoparesis, and urinary and fecal incontinence. A picture consistent with cerebral angiitis was seen angiographically. After systemic angiitis and CNS infection were excluded, the diagnosis of isolated angiitis of the central nervous system was made. The patient responded well to corticosteroid therapy. However, a few months after initial presentation, he developed signs and symptoms suggestive of hydrocephalus. Serial CT scans of the head and radioisotope cisternography confirmed this diagnosis. The communicating hydrocephalus that developed was considered a complication of the CNS angiitis. A review of the literature on angiitis of the CNS is presented and the mechanism of the development of hydrocephalus is discussed.