A rare case of racemose neurocysticercosis and its complications. Case report

Abstract

Neurocysticercosis is a central nervous system infection caused by the pork tapeworm Taenia solium. The disease is endemic in Central and South America, Asia and Africa. Racemose neurocysticercosis refers to cysts in the subarachnoid space and is characterized by proliferative lobulated cysts without a scolex. We report a case of a 43-year-old woman with an eight-month history of headaches, ataxia and loss of vision. CT and MRI showed an intraventricular cyst, causing entrapment of Monro foramina and hydrocephalus, smaller cysts at subarachnoid space in temporal lobes, Sylvian fissures, supra-selar and perimesencephalic cisterns, and an intra-orbital cyst. Additionally, there were acute ischemic vascular lesions on the left thalamus and corpus callosum splenium and subacute ischemic lesions of both occipital lobes. The diagnosis of racemose cysticercosis was made after biopsy and drainage of the intraventricular cyst. It is important to recognize neurocysticercosis as a differential diagnosis in intra-cranial cysts, not only intraparenchymal cysts.

Subarachnoid Cysticercosis and Ischaemic Stroke in Epileptic Patients

“…Usually, the scolex is absent and multiple complex small cysts may form (cluster of grapes), filling the basal cisterns, determining mass effect and distortion of adjacent structures, namely sulci, brainstem and cranial nerves [43][44][45], these authors consider that in racemose NCC, there is a presence of abnormally large growths of many cystic membranes without a scolex, normally without enhancement, in subarachnoid space and basal cisterns and they found on imagenology that the cysts have a thin wall without a scolex; their signal is isointense or slightly different from CSF, hypointense on T1-weighted images (T1-WIs) and fluid-attenuated inversion recovery (FLAIR), hyperintense on T2-WI, without diffusion restriction, and after contrast there is no wall enhancement. A three-dimensional balanced steady-state free precession sequence (constructive interference in steady state (CISS)), driven equilibrium (DRIVE) or contrast-enhanced MR cisternography helps to detect the underlying cysts [46]. Pamplona et al [46] reported a case of a 43-year-old woman from…”

“…A three-dimensional balanced steady-state free precession sequence (constructive interference in steady state (CISS)), driven equilibrium (DRIVE) or contrast-enhanced MR cisternography helps to detect the underlying cysts [46]. Pamplona et al [46] reported a case of a 43-year-old woman from…”

“…Almost all clinical presentations of stroke can be seen in epileptic patients having SNCC [27,41,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. Despite the increasing number of reports on haemorrhagic stroke to the medical literature [19, 20, 23, 24, 26, 27, 29-31, 37-41, 47-62], the prevalence of stroke secondary to NCC remains higher in IS secondary to infectious vasculitis.…”

“…relationship between neurocysticercosis and the cerebral infarct by showing abnormalities compatible with cysticercotic arachnoiditis. Pamplona et al[46] reported a case of a 43-yearold woman with an eight-month history of headaches, ataxia and loss of vision. CT and MRI showed an intraventricular cyst, causing entrapment of Monro foramina and hydrocephalus, smaller cysts at subarachnoid space in temporal lobes, Sylvian fissures, suprasellar and peri-mesencephalic cisterns, and an intra-orbital cyst.…”

Racemozse neurocysticercosis

“…The recent report by Pamplona et al on racemose neurocysticercosis is very interesting. 1 Pamplona et al concluded that ''it is important to recognize neurocysticercosis as a differential diagnosis in intra-cranial cysts, not only intraparenchymal cysts.'' 1 Indeed, neurocysticercosis can be seen at any part of the neurological system.…”