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Washington University Experience | MISCELLANEOUS | Neurosarcoid - no PNS | 13A0 Case 13 History
Case 13 History ---- The patient is a 73-year-old woman with 4-6 months of progressive ataxia, occasional dizziness, low grade fever, blurred vision without diplopia, and a 40-pound weight loss. MRI showed diffuse nodular leptomeningeal enhancement of the parieto-occipital cortex, brain stem, fourth ventricle, posterior fossa and spinal cord. CSF cytology revealed lymphocytic pleocytosis without evidence of lymphoma; glucose 22, protein 393, white blood cell count 188. PET scan showed increased FDG uptake in two left hilar lymph nodes. She underwent craniotomy and biopsy of the cerebellopontine angle and lateral cerebellar mass. Post-operatively, she showed a right-sided gaze preference, progressive nausea and vomiting, as well as some confusion. Computed tomography of the head revealed hydrocephalus, swelling and mild hemorrhage in the posterior fossa, necessitating a return to the operating room. Operative procedure: External ventriculostomy and cerebellar biopsy.
