NEUROCYSTICERCOSIS - FOCUS ON INTRAVENTRICULAR DISEASE

Intraventricular neurocysticercosis is of concern because it is associ ated with a poorer prognosis than is parenchymatous disease. Frequentl y, associated hydrocephalus occurs, which may recur after treatment. W e report on 11 patients with intraventricular cysticercosis (from a la rger case series of 33 patients) and evaluate clinical presentations, neuroimaging findings, and responses to treatment, especially of ventr icular disease. Intraventricular cysticercosis represented 33% of our cases. Seven patients presented with increased intracranial pressure; four required ventriculoperitoneal shunting. Parenchymatous symptomati c cysticercosis is largely a result of the host inflammatory response, presenting in our series with epileptic seizures in 73% of the patien ts (tonic clonic generalized seizures occurred in 64% and partial simp le seizures in 9%), The prognosis for parenchymatous inflammatory dise ase is good. We advocate the use of anthelmintic treatment with albend azole in all cases of intraventricular cysts, and if hydrocephalus occ urs, then shunt procedures or ventriculostomy is necessary. These pati ents must be monitored closely for recurrent hydrocephalus.