Hydrocephalus in Wegener’s Granulomatosis: Neuroendoscopic Findings and Management
Bibliographic record
Abstract
To the Editor: Wegener’s granulomatosis (WG) is a systemic disease characterized by inflammatory changes of small and medium-size blood vessels. The clinical features in correlation with histopathology were initially described by Wegener in 19361. The disease is associated with granuloma formation and necrosis of the upper airway, lungs, and kidneys2, although other organs can also be affected. The nervous system is involved in up to 33% of cases, with the peripheral nervous system most commonly affected. Involvement of the central nervous system (CNS) is highly unusual3. Similarly, hydrocephalus is very uncommon, occurring in only 4 previously documented cases4,5,6,7. We describe an unusual case of WG with pachymeningitis and aqueductal stenosis resulting in hydrocephalus in a patient who underwent neuroendoscopic exploration of the ventricular system. We believe this is the first report of WG-associated hydrocephalus secondary to aqueductal stenosis effectively managed with cerebral endoscopy. A 33-year-old right-handed white man with WG presented to the emergency department with symptoms of subacute onset of headache, neck and retroorbital pain, diplopia, … Address correspondence to Dr. Rangel-Castilla; E-mail: LRcastilla{at}tmhs.org
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.010 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".