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Reversal of syphilitic hydrocephalus with intravenous penicillin
M Cosottini1, M Mascalchi, G Zaccara
1Clinica Neurologica II, Università di Firenze, Florence, Italy.
Background:
CSF shunting procedures are generally considered the fundamental therapy of syphilitic hydrocephalus.
Methods:
We followed up with CSF analysis and MR imaging a patient with progressive mental and gait disturbances and tetraventricular hydrocephalus due to tertiary syphilis who was treated for 14 days with high dose intravenous penicillin alone.
Results:
Clinical and CSF abnormalities resolved within a few months, whereas the hydrocephalus disappeared only 30 months after therapy.
Conclusions:
Before consideration of a CSF shunting procedure, a trial of high dose intravenous penicillin is warranted for patients with syphilitic hydrocephalus.