SUBARACHNOID HEMORRHAGE SECONDARY TO A RUPTURED INFLAMMATORY ANEURYSM- A POSSIBLE MANIFESTATION OF NEUROCYSTICERCOSIS - CASE-REPORT

WE REPORT A case of a 32-year-old man who presented with subarachnoid hemorrhage. As revealed by lumbar puncture, the cerebrospinal fluid ha d low glucose, high protein levels, and pleocytosis with 5% of eosinop hils. Cultures were negative. Enzyme-linked immunosorbent assay and co mplement fixation reactions for cysticercosis in cerebrospinal fluid w ere positive. An angiogram revealed an aneurysm of the right anteroinf erior cerebellar artery. At surgery, the aneurysm was found to be surr ounded by thickened leptomeninges, which histologically presented dens e inflammation and remains of Cysticercus. The aneurysm could not be c lipped, and it was wrapped. Postoperatively, the patient had dizziness and right ear tinnitus. He received prednisone therapy on alternate d ays and subsequently received albendazole for subarachnoid cysticerci. At the 4-year follow-up, the patient was asymptomatic and had normal cerebrospinal fluid. Although we cannot rule out a congenital aneurysm , its location inside an area of severe arachnoiditis around a cystice rcus suggests an inflammatory origin, This type of vascular lesion not reported before should be suspected in patients with chronic cysticer cotic meningitis.