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Cerebral cysticercosis: a case report
K Higashi1, T Yamagami, G Satoh
1Department of Neurosurgery, Ijinkai Takeda General Hospital, Kyoto, Japan.
Abstract:
A case of cerebral cysticercosis is reported in a 49-year-old female who presented with headache, nausea, and vomiting. Lumbar CSF showed the findings of mild aseptic meningitis. CT scan revealed an enlargement of the left ambient cistern and a small cystic lesion in the left frontal cortex. MRI demonstrated multilobular cysts in the left ambient cistern with enhancement of their capsules, which compressed and distorted the midbrain. The cysts were surgically excised, and histological examination of the specimen disclosed characteristic features of cysticercus with viable larva. An excellent value of MRI in the diagnosis of intracisternal cysticercosis is emphasized.
Insights
Cerebral cysticercosis, a parasitic brain infection, was diagnosed in a woman presenting with severe headaches. Magnetic resonance imaging (MRI) proved highly effective in identifying the intracisternal cysts causing her symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Cerebral cysticercosis is a significant parasitic infection of the central nervous system.
- Diagnosis often relies on a combination of clinical presentation, cerebrospinal fluid analysis, and neuroimaging.
Observation:
- A 49-year-old female presented with headache, nausea, and vomiting, alongside mild aseptic meningitis on lumbar cerebrospinal fluid (CSF) analysis.
- Computed tomography (CT) revealed an enlarged left ambient cistern and a frontal cortical lesion.
- Magnetic resonance imaging (MRI) precisely delineated multilobular cysts within the left ambient cistern, causing midbrain compression and distortion.
Findings:
- Surgical excision and histological examination confirmed the presence of viable cysticercus larva.
- MRI demonstrated characteristic features of intracisternal cysticercosis, including capsular enhancement and mass effect.
Implications:
- This case highlights the diagnostic superiority of MRI for intracisternal cysticercosis.
- Accurate diagnosis through advanced neuroimaging is crucial for timely surgical intervention and patient management.
- Understanding the radiological manifestations aids in differentiating cysticercosis from other neurological conditions.