CASE REPORT: Hydrocephalus as a rare presentation of neurosarcoidosis

Background : Neurosarcoidosis represents a rare manifestation of sarcoidosis, with hydrocephalus occurring in only 5-9% of cases. Observation: A 56-year-old female presented with severe hydrocephalus. Initial management involved a third ventriculostomy. Subsequent diagnostic evaluations confirmed neurosarcoidosis. However, before initiating medical treatment, recurrent hydrocephalus required reopening of the third ventriculostomy. The patient is currently undergoing a therapeutic regimen comprising methotrexate and infliximab, no new manifestations of hydrocephalus were observed following the reoperation. Conclusions: In cases where obstructive hydrocephalus is associated with neurosarcoidosis, the prompt initiation of steroid treatment is imperative. Delays may contribute to the risk of relapse, underscoring the importance of timely medical management.