A 50-year-old woman presented with a severe obstructive hydrocephalus, only temporarily relieved by shunts. The diagnosis of sarcoidosis was suspected but never proven. Autopsy revealed multisystem sarcoidosis as well as widespread involvement of the CNS. The cause of hydrocephalus was established as occlusion of the aqueduct by subependymal granulomas and massive gliosis obliterating the lumen.
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