Neurosarcoidosis is generally expressed by various symptoms; it is exceptionally revealed by hydrocephalus. We report a 27-year-old African man hospitalized with acute neurological deterioration due to hydrocephalus. The treatment consisted of ventriculostomy and corticosteroid therapy; however a permanent shunt was not required. After six months of follow-up, the patient had fully recovered. Clinical presentation, neuroimaging findings and treatment modalities are discussed.