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Neurosarcoid infiltration of the ventricular catheter causing shunt failure: a case report
A H Maniker1, E S Cho, M Schulder
1University of Medicine, New Jersey Medical School, Newark, USA.
Background:
Neurosarcoid is known to develop in 5% of patients with sarcoidosis. 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 multiple shunt failures.
Results:
On two revisions, the proximal catheter, after removal, was found to be occluded with noncaseating granulomatous material that had infiltrated the shunt lumen.
Conclusions:
Although shunts may become occluded by inspissated proteinaceous or cellular debris, the occlusion of a shunt catheter by the ingrowth of the noncaseating granulomatous material of neurosarcoid has not been described before. This patient's course, the histopathologic findings, and neurosarcoidosis in general are discussed here.
