Fourth ventricle neurocysticercosis: A case report

Abstract

Background:Neurocysticercosis (NCC) is the most common helminthic disease of the nervous system in humans and it is caused by the larvae of the pork tapeworm, Taenia solium. We present a case of microsurgical removal of a fourth ventricle NCC cyst combined with an endoscopic third ventriculostomy (ETV) to treat hydrocephalus.Case Description:A 36-year-old woman presented to the emergency room with headache and decreased visual acuity over the last 4 months. A brain magnetic resonance imaging showed obstructive hydrocephalus apparently correlated to a mobile, cystic lesion of the fourth ventricle. In the same operative time, an ETV and a suboccipital craniotomy were performed in order to remove the lesion and to treat the hydrocephalus. The cyst was completely removed and pathologically identified as a T. solium cyst. The early postoperative course was uneventful and she was discharged asymptomatic and off anthelmintic medication. Five weeks later, the patient returned with hydrocephalus recurrence and was successfully retreated with an ETV. At 5-month follow-up, she remains asymptomatic and has no evidence of persistent disease or hydrocephalus recurrence.Conclusion:Intraventricular neurocysticercosis is, typically, a surgical disease. For cysts located on the fourth ventricle, a suboccipital craniotomy and a telovelar approach remains a valid option. Cyst removal does not necessarily resolve the hydrocephalus problem. ETV offers an option to the classic shunt placement approach and was shown to be effective even on hydrocephalus recurrence.

Hemorrhagic Fourth Ventricle Colloid Cyst: A Report of an Unusual Presentation at an Uncommon Location

“…On the other hand, the endoscopic method appears to be more difficult and needs special expertise, especially when the cyst is attached to the ependymal lining or when there is a thin aqueduct. 16 In contrast to colloid cysts in the third ventricle, the location of the cyst in our case obviated the use of endoscopy or stereotactic aspiration. Our recommended treatment plan was suboccipital craniotomy and the telovelar approach with microsurgical excision due to the cyst's size and hemorrhagic nature, as well as additional differentials to be addressed.…”

Chronic administration of cryptolepine nanoparticle formulation alleviates seizures in a neurocysticercosis model

“…Several studies have identified the occurrence of inflammatory processes such as meningitis, edema, hyperemia, microgliosis and calcification and fibrosis in neurocysticercosis ( Nash and Garcia, 2011 ; Simão et al., 2018 ). Edema as well as inflammation around lesions and meningitis have been observed in extra-parenchymal neurocysticercosis of which intraventricular is the most common ( Anadure et al., 2020 ).…”

Intrasellar cysticercosis cyst treated with a transciliary supraorbital keyhole approach – A case report

“…The extraparenchymal form that accounts for 15–30% of the cases has variable clinical manifestations including intracranial hypertension, cranial nerve abnormalities, and hydrocephalus. [ 11 , 17 ] Sellar NCC was also eventually recognized in autopsy series of patients with NCC,[ 3 , 5 ] increased awareness of intrasellar NCC only came after the introduction of modern neuroimaging diagnostic methods. In 1985 and 1988, the first series of eight patients with intrasellar cysticercosis was reported from Mexico City.…”