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Neuroendoscopic Management of Lateral Ventricular Neurocysticercosis Presenting as Brun's Syndrome
Ashish Chugh1, Sarang Gotecha1, Prashant Punia1
1Department of Neurosurgery, Dr. D. Y. Patil Medical College and Hospital, Sant Tukaram Nagar, Pimpri Pune, Maharashtra, India.
Background:
Brun's syndrome is a phenomenon characterized by sudden onset of severe headache, vomiting associated to a vestibular syndrome triggered by an abrupt movement of the head.
Case Presentation:
We present a case of a 12-year-old female patient with headache, vertigo, and vomiting; magnetic resonance imaging (MRI) was suggestive of a cystic intraventricular mass in the frontal horn of the left lateral ventricle. The patient underwent endoscopic exploration for the excision of cyst with complete postoperative recovery and histopathology suggestive of intraventricular neurocysticercosis.
Discussion:
Brun's syndrome is caused by a mobile deformable intraventricular mass leading to an episodic obstructive hydrocephalus resulting from an intermittent or positional CSF obstruction with elevation of intracranial pressure due to the ball valve mechanism. Treatment is mainly surgical, preferably by the neuroendoscopic technique as it has an advantage of performing septostomies and third ventriculostomies in addition to cyst removal, making this procedure practical for most cases of ventricular cysticercosis even in emergencies.
