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Updated: Jan 12, 2026
Endoscopic Approach for Colloid Cyst Resection
Published on: May 23, 2025
Endoscopic management of intraventricular and subarachnoid neurocysticercosis: technical workflow and clinical
Xinghua Xu1, Jiashu Zhang1, Zhiwang Guo1,2
11Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Objective:
Intraventricular and subarachnoid neurocysticercosis (IVSN) represents a severe extraparenchymal manifestation of Taenia solium infection, frequently leading to obstructive hydrocephalus and increased intracranial pressure. Despite advances in medical therapy, standardized protocols for endoscopic management remain lacking. The authors aimed to establish a comprehensive diagnostic and surgical workflow for IVSN and evaluate the clinical outcomes of neuroendoscopic management in a large single-center cohort.
Methods:
The medical records of 51 patients (mean age 43.4 years, 68.6% male) with IVSN treated via endoscopic surgery from 2009 to 2025 were retrospectively reviewed. Preoperative diagnostics included high-resolution T2-weighted 3D SPACE MRI and lateral view radiographic imaging of the lower legs to enhance the detection of cysts. Endoscopic procedures involved cyst excision, endoscopic third ventriculostomy, and septostomy. Postoperative management included corticosteroids, albendazole, and antiepileptics. Outcomes were assessed via radiological follow-up and clinical monitoring over a mean period of 98.3 months.
Results:
Complete cyst removal was achieved in 88.2% of patients. Three-dimensional SPACE (sampling perfection with application-optimized contrast using different flip angle evolutions) MRI enabled clear visualization of cyst membranes in all cases, outperforming conventional sequences. Intramuscular calcifications were detected in 94.1% of patients via lateral leg radiographic imaging. The recurrence rate was 2.0%, and only 9.8% of patients required ventriculoperitoneal shunt placement. Postoperative complications were minimal, with intracranial infections in 2 cases (3.9%), both of which were successfully managed. No neurological deficits were observed following surgery.
Conclusions:
Neuroendoscopic surgery offers a safe and effective treatment for IVSN when combined with advanced imaging and structured medical therapy. The integration of 3D SPACE MRI and standardized endoscopic protocols facilitates accurate diagnosis, complete cyst removal, and long-term disease control with low complication and recurrence rates.
