Ventricular Neurocysticercosis Presenting as Hydrocephalus: A Treatment Experience Sharing

Neurocysticercosis (NCC), particularly ventricular involvement, poses significant management difficulties. The authors report a case of third ventricular NCC causing obstructive hydrocephalus. A 48-year-old male presented with progressive gait instability. MRI revealed nodular lesions obstructing the aqueduct. Initial CSF immunology was negative, but next-generation sequencing (NGS) confirmed Taenia solium infection. Endoscopic third ventriculostomy with Ommaya reservoir placement was performed, followed by combined albendazole-praziquantel therapy. Controlled CSF drainage through the reservoir mitigated treatment-induced inflammation. Complete symptom resolution was achieved at 2-month follow-up. This case highlights: (1) CSF NGS as a crucial diagnostic tool when histology is unattainable, (2) the efficacy of combined antiparasitic therapy, and (3) the dual role of Ommaya reservoirs in managing hydrocephalus and treatment-related complications.