"Malignant" Craniospinal Neurocysticercosis: A Rare Case.

Arachnoiditis Craniospinal Hydrocephalous Intradural Intraventricular Neurocysticercosis

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
02 2021
Historique:
received: 29 07 2020
revised: 22 10 2020
accepted: 23 10 2020
pubmed: 1 11 2020
medline: 22 6 2021
entrez: 31 10 2020
Statut: ppublish

Résumé

Neurocysticercosis (NCC) is the commonest parasitic infection of the central nervous system. There is significant difference in incidence of NCC depending on geographic location, and incidence as high as 4% is reported in the endemic areas. It results from human affliction by the larval stage of Taenia solium. Spinal NCC is quite rare as compared with cranial NCC and accounts for 1.5%-3% of all cases. Both spine and cranium can be rarely involved in NCC, and cranial involvement usually precedes the spinal involvement. We report a case of a 51-year-old woman who had spinal involvement first in the form of spinal intradural extramedullary disease and then developed cranial involvement more than 1 year later. She developed spinal arachnoiditis. She developed communicating hydrocephalous requiring ventriculoperitoneal shunt. Later she developed isolated fourth ventricle and required excision of the fourth ventricular NCC. The unique aspects of our patient were a very aggressive course and involvement of cranium after spinal involvement. We describe her clinical course over 3 years and the management done. NCC can sometimes follow a very aggressive course and can involve both cranial and spinal compartments. Management of such patients is not standardized given the rarity of such cases.

Sections du résumé

BACKGROUND
Neurocysticercosis (NCC) is the commonest parasitic infection of the central nervous system. There is significant difference in incidence of NCC depending on geographic location, and incidence as high as 4% is reported in the endemic areas. It results from human affliction by the larval stage of Taenia solium. Spinal NCC is quite rare as compared with cranial NCC and accounts for 1.5%-3% of all cases. Both spine and cranium can be rarely involved in NCC, and cranial involvement usually precedes the spinal involvement.
CASE DESCRIPTION
We report a case of a 51-year-old woman who had spinal involvement first in the form of spinal intradural extramedullary disease and then developed cranial involvement more than 1 year later. She developed spinal arachnoiditis. She developed communicating hydrocephalous requiring ventriculoperitoneal shunt. Later she developed isolated fourth ventricle and required excision of the fourth ventricular NCC. The unique aspects of our patient were a very aggressive course and involvement of cranium after spinal involvement. We describe her clinical course over 3 years and the management done.
CONCLUSIONS
NCC can sometimes follow a very aggressive course and can involve both cranial and spinal compartments. Management of such patients is not standardized given the rarity of such cases.

Identifiants

pubmed: 33127574
pii: S1878-8750(20)32323-8
doi: 10.1016/j.wneu.2020.10.121
pii:
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

95-102

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Kanwaljeet Garg (K)

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India. Electronic address: kanwaljeet84@gmail.com.

Vaibhav Vij (V)

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Ajay Garg (A)

Department of Neuroimaging & Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India.

Manmohan Singh (M)

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Poodipedi Sarat Chandra (PS)

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

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