Federico Arturo Silva Sieger

Mercury chronic toxicity might be associated to some cases of hydrocephalus in adult humans

Mercury accumulates in nervous tissue causing neurological and psychiatric manifestations. Numerous clinical findings have been described in patients that suffered chronic mercury intoxication. Some findings, such as hydrocephalus, have been described only in experimental studies. Following, we present a case of 50 year-old man with a 3-month history of severe frontal headache episodes and vision loss together with a history of asthenia, anorexia, muscle pain, fatigue and neuropsychiatric symptoms. The magnetic resonance imaging showed hydrocephalus and stenosis of aqueduct of Sylvius. This patient reported that he worked as laboratory metallurgic auxiliary for over 30 years. During this time, he had been chronically exposed to elemental mercury. The metals whole blood test was normal, except by his blood mercury level that was 61.5 μg/L (normal ~1 μg/L). In our best knowledge, hydrocephalus and stenosis of aqueduct of Sylvius have been described only in animals exposed to methylmercury during their gestation. We think that this case of hydrocephalus might be associated with the chronic mercury exposure and therefore this etiology must be taken in account in a patient with hydrocephalus of unknown etiology.