Reversal of syphilitic hydrocephalus with intravenous penicillin

Can J Neurol Sci. 1997 Nov;24(4):343-4. doi: 10.1017/s0317167100033035.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Brain / pathology
  • Humans
  • Hydrocephalus / cerebrospinal fluid
  • Hydrocephalus / drug therapy*
  • Hydrocephalus / etiology*
  • Infusions, Intravenous
  • Lactams
  • Magnetic Resonance Imaging
  • Male
  • Neurosyphilis / cerebrospinal fluid
  • Neurosyphilis / complications*
  • Neurosyphilis / drug therapy*
  • Neurosyphilis / pathology
  • Penicillins / administration & dosage
  • Penicillins / therapeutic use*


  • Anti-Bacterial Agents
  • Lactams
  • Penicillins