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Fourth ventricle neurocysticercosis: A case report
Diogo Simão1, Joaquim C Teixeira1, Alexandre R Campos1
1Department of Neurosurgery, Centro Hospitalar Lisboa Norte, Lisboa, Portugal.
Surgical Neurology International
|November 3, 2018
Summary
Neurocysticercosis (NCC) is a common nervous system disease. Microsurgical removal of fourth ventricle cysts combined with endoscopic third ventriculostomy (ETV) effectively treats hydrocephalus, even with recurrence.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Neurology
Background:
- Neurocysticercosis (NCC) is the most common helminthic disease of the human nervous system, caused by *Taenia solium* larvae.
- Intraventricular NCC, particularly in the fourth ventricle, presents unique surgical challenges.
Observation:
- A 36-year-old woman with obstructive hydrocephalus due to a mobile fourth ventricle cyst underwent simultaneous microsurgical cyst removal and endoscopic third ventriculostomy (ETV).
- The cyst was identified as *Taenia solium*. Postoperative course was initially uneventful, but hydrocephalus recurred after five weeks.
Findings:
- Complete removal of the fourth ventricle *Taenia solium* cyst was achieved.
- Recurrent hydrocephalus was successfully managed with a repeat ETV, demonstrating its efficacy in managing persistent or recurrent CSF flow obstruction.
- The patient remained asymptomatic at 5-month follow-up without evidence of disease recurrence or hydrocephalus.
Implications:
- Microsurgical removal of fourth ventricle NCC is a viable option.
- Endoscopic third ventriculostomy (ETV) provides an effective alternative to shunting for hydrocephalus management in NCC, even in cases of recurrence.
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