Clinical and radiographic response of fourth ventricle cysticercosis to praziquantel therapy

Fandiño, Javier; Botana, C.; Fandiño, C; Rodriguez, Daniel A.; Gomez-Bueno, J.

doi:10.1007/bf01400502

Cited by 13 publications

(6 citation statements)

References 19 publications

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“…Intraventricular cysticercosis represents 15 to 33 % of neurocysticercosis [2,3]. There is an increased trend towards managing intraventricular cysts medically with reasonably good results [1,4,5,9,11]. However, the numbers are few and some required a shunting procedure for hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Approach to Intraventricular Cysticercal Lesions

Anandh

Mohanty

Somanna

et al. 2001

Minim Invasive Neurosurg

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Various surgical approaches to treat intraventricular cysticercosis have been practiced over the years. We now present our experience with the use of the endoscope in the removal of intraventricular cysticercal cysts in patients with intraventricular cysticercal lesions associated with hydrocephalus. From 1995 to 1998, we have excised intraventricular cysticercal cysts from 9 patients. They were located in lateral ventricle in 4, in the third ventricle in two and in the fourth ventricle in three patients. A Gaab's rigid neuroendoscope system was used to enter and excise cysts in the lateral and third ventricle. The flexible fiberoptic scope was used for excising cysts in the fourth ventricle, through a transaqueductal route. In all cases a precoronal frontal burr hole was used for entry. All have been treated with albendazole in the postoperative period. All the cysts were removed successfully using endoscopic neurosurgery alone. One patient had a superficial injury to the rigid side of the aqueduct with a postoperative deficit, which improved. Three septal perforations, three third ventriculostomies, and one aqueductoplasty were done in the same sitting after cyst removal for CSF diversion. None of the nine cases required further surgery up to date. The follow-up period varied from 12 to 45 months with a median of 18 months. Endoscopic neurosurgery is a minimally invasive technique enabling removal of intraventricular cyticercal cysts from all locations, avoiding major craniotomies/posterior fossa explorations and shunts.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Approach to Intraventricular Cysticercal Lesions

Anandh

Mohanty

Somanna

et al. 2001

Minim Invasive Neurosurg

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“…[7] In 1991, two more cases were published describing cysticercosis of the fourth ventricle treated with VP shunt placement and praziquantel treatment. In one case, the cyst disappeared, leaving a calcification, [11] and in the second, it decreased in size. [1] No adverse effects were reported in any of the three cases mentioned, and the patients improved.…”

Section: Discussionmentioning

confidence: 90%

“…or albendazole have raised some controversy. [1,7,11] The latter is the drug of choice for the treatment of the cerebral parenchymatous type of neurocysticercosis and has an efficacy rate of 85% after one course. [21] Multiple studies corroborate an approximate efficacy rate of 60% [8] for praziquantel.…”

mentioning

confidence: 99%

Albendazole and praziquantel treatment in neurocysticercosis of the fourth ventricle

Proaño¹,

Madrazo²,

García³

et al. 1997

FOC

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The purpose of this study was to determine the therapeutic efficacy of albendazole and praziquantel administration in the treatment of neurocysticercosis of the fourth ventricle. The authors report the results obtained in 10 patients with cystic neurocysticercosis of the fourth ventricle who were treated with albendazole at a dosage of 15 mg/kg/day for 2 weeks. Because of the failure of albendazole treatment, two of the patients received an additional course of praziquantel at a dosage of 100 mg/kg/day for 2 weeks. A total of 16 courses of albendazole and two courses of praziquantel were administered to the 10 patients. In seven patients (70%), there was complete disappearance of the cyst, in two others (20%) there was an important decrease in the size of the cyst, and in one (10%), no change was seen. None of the patients had complications during the follow-up period of between 6 and 26 months (average 15.7 months). The authors postulate that a regimen of albendazole is the treatment of choice for this type of neurocysticercosis, although praziquantel may also be useful.

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“…[4,12,37] This is largely based on anecdotal reports of patients with cysts located in the fourth ventricle successfully treated with praziquantel or albendazole. [2,16,17,21,37] Cysts have been documented to disappear as early as the 3rd month after treatment. [12] Others have argued that neither praziquantel nor albendazole is indicated in the treatment of intraventricular cysticercosis.…”

Section: Indications For Use Of An Endoscopic Surgical Approachmentioning

confidence: 99%

Endoscopic removal of cysticercal cysts within the fourth ventricle: technique and results

Bergsneider¹

1999

FOC

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There is no consensus as to the optimum management of patients who harbor cysticercal cysts within the fourth ventricle. Compared with the alternative treatment options of anthelmintic medication and/or cerebrospinal fluid shunting, the surgical removal of the cyst has the advantage of eliminating the inflammatory nidus and potentially obviating the need for a complication-prone shunt. Here, an endoscopic surgical approach is described and proposed as a superior alternative to the suboccipital craniotomy for removal of a fourth ventricle cyst. A retrospective analysis was conducted to compare five consecutive endoscopic cases with eight previous consecutive cases in which a suboccipital craniotomy was performed to remove fourth ventricle cysticercal cysts. Comparisons are made with regards to success in removing the cyst, length of operation, surgical blood loss, postoperative discomfort, and complications. A detailed description of the endoscopic technique is given. Endoscopic removal of all cysts within the fourth ventricle was successful in each case. The mean length of operative times was shorter and the blood loss was reduced with the endoscopic procedure compared with the suboccipital craniotomy (2.5 ± 0.8 hours and 5.3 ± 2.2 hours [p = 0.02], 19 ± 4ml and 269 ± 203 ml [p = 0.02], respectively). The endoscopic procedure was safe and associated with less postoperative discomfort in most patients. In properly selected patients, the endoscopic removal of cysticercal cysts located within the fourth ventricle is superior to the suboccipital craniotomy and should be considered as the primary treatment for this condition.

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Clinical and radiographic response of fourth ventricle cysticercosis to praziquantel therapy

Cited by 13 publications

References 19 publications

Endoscopic Approach to Intraventricular Cysticercal Lesions

Endoscopic Approach to Intraventricular Cysticercal Lesions

Albendazole and praziquantel treatment in neurocysticercosis of the fourth ventricle

Endoscopic removal of cysticercal cysts within the fourth ventricle: technique and results

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