Bruns syndrome caused by intraventricular neurocysticercosis treated using flexible endoscopy

Torres-Corzo, Jaime Gerardo; Vecchia, Roberto Rodríguez-Della; Rangel-Castilla, Leonardo

doi:10.3171/jns.2006.104.5.746

Cited by 60 publications

(40 citation statements)

References 15 publications

(13 reference statements)

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“…Actualmente, se utiliza la derivación ventrículo-peritoneal para disminuir la hipertensión intracraneal y la cirugía mínima-mente invasiva con neuroendoscopio flexible para la resección y absorción de los quistes (22)(23)(24)(25).…”

Section: Discussionunclassified

Racemose neurocysticercosis - neuroimaging guide the diagnosis

2016

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: revisión bibliográfica, desarrollo de la estructura del manuscrito, revisión y seguimiento de los casos clínicos Sergio Alberto Vargas: diagnóstico neurorradiológico, estructura y revisión del manuscrito Carlos Santiago Uribe: diagnóstico neurológico, revisión y discusión de los casos clínicos La neurocisticercosis es la primera causa de parasitosis del sistema nervioso central y de epilepsia adquirida en países en desarrollo. Sus manifestaciones clínicas, especialmente de la variante racemosa (sic), son pleomorfas e inespecíficas, características que hacen de su diagnóstico un desafío para el clínico. El objetivo de este informe fue describir dos casos de neurocisticercosis racemosa (sic), en los cuales las neuroimágenes permitieron hacer el diagnóstico definitivo. El primer caso se trató de una paciente con cefalea persistente y signos neurológicos focales, que requirió múltiples exámenes paraclínicos para, finalmente, llegar al diagnóstico definitivo de neurocisticercosis racemosa (sic) con vasculitis cerebral secundaria. A pesar del tratamiento médico y quirúrgico, la paciente falleció después de diversas complicaciones. El segundo caso se trató de una paciente con antecedentes de neurocisticerosis, que consultó por vómito crónico incoercible y, también requirió múltiples exámenes paraclínicos para concluir que se trataba de un vómito de origen central, secundario a neurocisticercosis racemosa (sic) y obstrucción del cuarto ventrículo. Después del tratamiento médico y quirúrgico, la paciente presentó una leve mejoría. En estos dos casos se evidenció que la adecuada interpretación de las neuroimágenes es fundamental para el diagnóstico de la neurocisticercosis racemosa (sic).

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Section: Discussionunclassified

Racemose neurocysticercosis - neuroimaging guide the diagnosis

2016

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“…During the course of the disease, the patient had critical days with acute headache, dizziness, complete abnormal gait due to ataxia and lateralization with compromised state of consciousness, manifestations explained by Bruns syndrome (13)(14)(15).…”

Section: Case Presentationmentioning

confidence: 99%

Neurocysticercosis, unusual manifestations

et al. 2016

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CASE REPORT | Abstract |Neurocysticercosis is the most common parasitic infection in the central nervous system. This disease is presented when a person ingests Taenia solium eggs excreted in feces from another individual infected with taeniasis. In 50% of the cases, neurocysticercosis takes place in the brain parenchyma, and its appearance is less frequent in the posterior fossa and the spinal cord.The case of a patient with an atypical location of the parasite at the medulla oblongata, between parenchymal and spinal areas, is presented. The initial symptoms were common but its subsequent manifestations were similar to those of Bruns syndrome. Furthermore, the epidemiological profile of neurocysticercosis in Colombia, its control measures and prevention strategies were reviewed in this study. Keywords | Resumen |La neurocisticercosis es la infección parasitaria más frecuente en el sistema nervioso central; esta enfermedad se desarrolla cuando los huevos de Taenia solium excretados en heces de un individuo con teniasis son ingeridos por otra persona. La presentación de la neurocisticercosis tiene lugar en el parénquima cerebral en 50% de los casos, mientras que en la fosa posterior y en la médula espinal es menos frecuente.Se presenta el caso de un paciente que tuvo una ubicación exótica del parásito a nivel del bulbo raquídeo concomitando con la forma parenquimatosa y medular; las manifestaciones clínicas iniciales fueron las comunes, pero sus síntomas posteriores se caracterizaron por el síndrome de Bruns. Además, durante la investigación se revisó el perfil epidemiológico de la neurocisticercosis en Colombia y las medidas de control y de prevención. IntroductionThe most common parasitic infection of the central nervous system (CNS) is neurocysticercosis (NCC), caused by the larvae of the Taenia solium (1). In developing countries, there is a 90% prevalence of cases in which this disease is neglected (2), but due to the ease and accessibility of transportation and the large groups of migrant population, this disease can also be found in developed countries (3,4). The World Health Organization (WHO) considers cysticercosis as a serious public health issue (5,6). This infection appears in the brain parenchyma in 50% of cases, and less frequently, in intraventricular, subarachnoid, eye and cord areas (6).The case described in this research presents an unusual appearance in the medulla oblongata, along with the parenchymal and spinal form. NCC symptoms are very diverse, including, among the most frequently observed and described by the authors, headaches and convulsions (7). 80% of infections are completely asymptomatic and when symptoms arise, they are non-specific depending on the number of injuries, the development stage of the cysticercus and the larval location (8). The presence of cysticerci in the brain may be prolonged -10 to 20 years in asymptomatic state-(9,10) although, in many occasions, when headaches occur, this symptom is not considered important. The diagnosis of NCC is often confused with incide...

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“…The pathomechanism of the BS is not clear. Bruns believed the symptoms resulted from a change in the position of the cyst in the fourth ventricle with periodic blocking of the ventricular system on change of head posture and elevation of intracranial pressure due to a ball-valve mechanism 6,8 . The diagnosis of NCC is difficult because clinical manifestations are nonspecific.…”

Section: Palavras-chavesmentioning

confidence: 99%

“…When feasible, complete surgical excision of lesions remains the definitive therapy [5][6] . In patients with hypertension, the priority is to manage the hypertension problem before considering any other form of therapy.…”

Section: Palavras-chavesmentioning

confidence: 99%

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Bruns' syndrome and racemose neurocysticercosis: a case report

Rodriquez

Crestani

Soares

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Cysticercosis is an infection caused by the larval stage of the tapeworm Taenia solium. The parasite may infect the central nervous system, causing neurocysticercosis (NCC). The clinical manifestations depend on load, type, size, location, stage of development of the cysticerci, and the host's immune response against the parasite. The racemose variety occurs in the ventricles or basal cisterns and is a malignant form. Mobile ventricular mass can produce episodic hydrocephalus on changing head posture with attacks of headache, vomiting, and vertigo, triggered by abrupt movement of the head, a phenomenon called Bruns' syndrome (BS). We report a patient with racemose NCC and BS.

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Bruns syndrome caused by intraventricular neurocysticercosis treated using flexible endoscopy

Cited by 60 publications

References 15 publications

Racemose neurocysticercosis - neuroimaging guide the diagnosis

Racemose neurocysticercosis - neuroimaging guide the diagnosis

Neurocysticercosis, unusual manifestations

Bruns' syndrome and racemose neurocysticercosis: a case report

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