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June 30, 2015: Intraventricular neurocysticercosis

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Brought to you by the Residents & Fellows Section of Neurology.

June 30, 2015

Intraventricular neurocysticercosis

Neurocysticercosis (NCC) is a central nervous system infection caused by the larval form of Taenia solium, with symptoms varying widely among affected individuals. Parenchymal lesions may result in seizures, and NCC is a major cause of epilepsy in developing countries. The intraventricular form of NCC is less prevalent, occurring in roughly 30% of infections 1. The third and fourth ventricles are most common sites of involvement and presenting symptoms are secondary to intracranial hypertension or mass effect from obstructive hydrocephalus 2. MRI is the preferred imaging modality for diagnosis as cyst contents and CSF share similar signal intensities on CT 1. Optimal treatment of intraventricular NCC is debated and may include endoscopic cyst removal, medical therapy with cysticidal agents and steroids, and ventriculoperitoneal (VP) shunt placement 1,2. In an observational, retrospective series of 140 patients with extraparenchymal NCC receiving albendazole or minimally invasive endoscopic cyst removal without cysticidal agents, patients in the surgical group had a decreased need for ongoing VP shunt placement and had an improved quality of life by Karnofsky scale evaluation 2.

References

  1. Sinha S and Sharma BS. Intraventricular neurocysticercosis: a review of current status and management issues. British Journal of Neurosurgery 2012; 26: 305-309.
  2. Proano JV, Torres-Corzo J, Rodríguez-Della Vecchia R, Guizar-Sahagun G, Rangel-Castilla L. Intraventricular and subarachnoid basal cisterns neurocysticercosis: a comparative study between traditional treatment versus neuroendoscopic surgery. Child's Nervous System 2009; 25: 1467-1475.

Submitted by Adam Numis, MD, Department of Neurology, University of California, Los Angeles.

Disclosures: Dr. Numis is a member of the Residents & Fellows Section of Neurology.

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