Neurocysticercosis: challenges in pediatric neurosurgery practice

Area of Science:

• Neurology
• Infectious Diseases
• Neurosurgery

Background:

• Neurocysticercosis (NCC) is a common parasitic central nervous system infection, often acquired in childhood and presenting in adulthood.
• While typically considered benign, NCC can severely impact quality of life through epilepsy, visual disturbances, and hydrocephalus, necessitating frequent hospitalizations.
• Hydrocephalus secondary to extraparenchymal NCC presents a significant neurosurgical challenge.

Approach:

• A concise review of pediatric neurocysticercosis and its neurosurgical presentations was conducted.
• A systematic review focused on hydrocephalus secondary to extraparenchymal NCC.

Key Points:

• Surgical treatment combined with medication achieved an approximately 80% complete resolution rate for hydrocephalus secondary to NCC on the first attempt.
• Endoscopic removal of intraventricular cysts combined with third ventriculostomy was the primary treatment modality.
• Patients treated with ventricular shunts previously showed poorer outcomes and increased complications.

Conclusions:

• The endoscopic approach is the gold standard for surgically managing hydrocephalus secondary to neurocysticercosis.
• Early and appropriate surgical intervention improves patient outcomes.