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Recurrent acute obstructive hydrocephalus as clinical onset of cerebral Whipple's disease

Vincenzo Seneca, Alessia Imperato, Giuseppe Colella, Valentina Cioffi, Giuseppe Mariniello, Michelangelo Gangemi
Clinical Neurology and Neurosurgery 2010, 112 (8): 717-21
Whipple's disease is a rare multisystemic infection caused by the intracellular bacteria Thropheryma whippelii. Central nervous system (CNS) involvement is not rare. The most frequent CNS manifestations are cognitive and behavioural changes, sopranuclear ophtalmoplegia, myoclonus, epilepsy, ataxia, meningitis and focal cerebral palsy. We report one case of cerebral localization of Whipple's disease with a clinical presentation of recurrent endocranic hypertension and hydrocephalus, and uncommon neurological symptoms, successfully treated by endoscopic third ventriculostomy and antibiotic therapy with ceftriaxone and Trimethoprim-Sulfamethoxazole.

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