Giant Neurocysticercosis
Keywords:
neurocysticercosis, parasitic infection of the nervous system, seizures and Taenia solium.Abstract
Introduction: Neurocysticercosis is the most common parasitic infection of the central nervous system. About 50 million people are infected in developing countries and it is considered endemic mainly in Latin America, Central America, Asia and Africa. Many individuals are asymptomatic, but in symptomatic individuals, clinical findings depend on the location, size, number of cysts and autoimmune process related to parasite aggression. Headache and seizures are the most common clinical manifestations. Treatment can be medical and surgical with variable prognosis.
Objective: To report a clinical case with a pathological diagnosis of solitary and giant neurocysticercosis.
Clinical case report: A 35-year-old male patient, with no personal medical history, came in with headache and generalized tonic-clonic seizures, which were not preceded by auras, and bladder sphincter relaxation. A simple computed tomography of the skull with contrast was performed, showing a left frontoparietal hypodense rounded lesion, approximately 8 cm in diameter, with a hyperdense mural nodule that caused a discrete mass effect on the structures of the midline and adjacent gyri without contrast uptake; compatible with giant cystic neurocysticercosis. A left frontoparietal craniotomy was performed with evacuation of the cyst and removal of the mural nodule.
Conclusions: Neurocysticercosis is a prevalent disease in Angola. Generally, treatment is clinical, but in some cases surgical intervention is recommended, specifically in patients with single and giant neurocysticercosis associated with irritative and deficit symptoms, obtaining a pathological diagnosis of the lesion.
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References
1. Cerdas C, Retana M, Ramírez G, Valenciano A. Neurocisticercosis parenquimatosa activa: reporte de un caso y revisión de la literatura. Rev Costarica Ciência Med. 2004 [acceso 28/10/2022];25:41-7. Disponible en: https://www.scielo.sa.cr//scielo.php?script=sci_arttext&pid=S0253-29482004000100005
2. Pal DK, Carpio A, Sander J. Neurocysticercosis and epilepsy in developing countries. J Neurol Neurosurg. Psychiatry. 2000;68(2):137-43. DOI: 10.1136/jnnp.68.2.137
3. Rodrigues Guimarães R, Orsini M, Rodrigues Guimarães R, Da Silva Catharino AM, Melo Reis CH, Silveira V, et. al.Neurocisticercose: Atualização sobre uma antiga doença. Rev Neurocienc. 2010;18(4):581-94. DOI: 10.34024/rnc.2010.v18.8444
4. Takayanagui OM, Leite JP. Neurocisticercose. Revista da Sociedade Brasileira de Medicina Tropical. 2001;34(3):283-90. DOI: 10.1590/S0037-86822001000300010
5. Del Brutto OH, Rajshekhar V, White Jr AC, Tsang VC, Nash TE, Takayanagui OM, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology. 2001;57(2):177-83. DOI: 10.1212/wnl.57.2.177
6. Colli NO, Carlotti Jr CG. Fisiopatologia, diagnóstico e tratamento da cisticercose do sistema nervoso central. Temas Atuais Neurocirurgia. 2003 [acceso 28/10/2022];1:4-28. Disponible en: https://neurodiagnose.com.br/wp-content/uploads/2021/02/cisticercose.pdf
7. Proaño JV, Madrazo I, Avelar F, López Félix B, Díaz G, Grijalva I. Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts. N Engl J Med. 2001;345:879-85. DOI: 10.1056/NEJMoa010212
8. González Álvarez AF, Liberratoscioli JC, Moliné T, Morales JC, Docampo J. Giant unilocular and vesicular neurocysticercosis: unusual presentation. Acta Neurol Belg. 2020;120(1):185-8. DOI: 10.1007/s13760-019-01254-9
9.Osvaldo MT, Tissiana MH. Update on the diagnosis and management of neurocisticercosis. Arq Neuropsiquiatr. 2022;80(5):296-306. DOI: 10.1590/0004-282X-ANP-2022-S115
10. Garcia HH. Antiparasitic drugs in neurocysticercosis: Albendazole or praziquantel? Expert Rev Anti Infect Ther. 2008;6:295-8. DOI: 10.1586/14787210.6.3.295
11. Goel RK, Ahmad FU, Vellimana AK, Suri A, Sarat Chandra P, Kumar R et al. Endoscopic management of intraventricular neurocysticercosis. J Clin Neurosci. 2018;15:1096-101. DOI: 10.1016/j.jocn.2007.10.004
12. Suller Marti A, Escalava AL, Burneo JG. Epilepsy surgery for refractory neurocisticercosis-related epilepsy. Rev Neurol. 2019;68(9):384-88. DOI: 10.33588/rn.6809.2018354
13. Espino PH, Couper RG, Burneo JG. An update on Neurocysticercosis-related epilepsy. Clin Neurol Neurosurg. 2022;213:107139. DOI: 10.1016/j.clineuro.2022.107139
14. Chimelli L, Lovalho AF, Takayanagui OM. Neurocysticercosis: contribution of autopsies in the consolidation of mandatory notification in Ribeirao Preto-SP, Brazil. Arq Neuropsiquiatr. 1998;56(3B):577-84. DOI: 10.1590/s0004-282x1998000400010
15. Nie D, Xia L, Chen J, Shi W, Sun G, Guo J. Teaching NeuroImages: Giant neurocysticercosis with inusual imaging manifestations Neurology. 2017;88(23):e234-e235. DOI: 10.1212/WNL.0000000000004055
16. Rocha Jr MA, Costa BS, Rocha CF, Rocha MA, Rocha CF, Carvalho GT, et al. Treatment of cerebral cysticercosis with albendazole in elevated dosages. Arq Neuropsiquiatria. 2008;66(1):114-6. DOI: 10.1590/S0004-282X2008000100032
17. Aljure V, Pulido Arias E, Rodrigues Monroy J, Rodriguez Mateus M, Ramos Hernández M. Diagnóstico diferencial de lesiones cerebrales con realce en anillo en tomografia computarizada y resonancia magnética. Duazary. 2016;13(2):149-58. DOI: http://dx.doi.org/10.21676/2389783X.1721
18. Mugundhan K, Balamurugan N, Chandrasekar P, Sivakumar S, Vasif Mayan MC, Nidhin PD. Giant Intraparanchymal Neurocysticercosis. J Assoc Physicians India. 2017 [acceso 28/10/2022];65. Disponible en: https://www.japi.org/y2e4b4/giant-intraparanchymal-neurocysticercosis
19. Guo J. Teaching NeuroImages: Giant neurocysticercosis with unusual imaging manifestations. Neurology. 2017;88(23):2238. DOI: 10.1212/WNL.0000000000004022
20. Del Brutto OH. Teaching NeuroImages: Giant neurocysticercosis with unusual imaging manifestations. Neurology. 2017;88(23):2238. DOI: 10.1212/WNL.0000000000004021
21. Santiago Brandão R, Wilker Nunes T, Dellaretti Filho MA, Fernandes Tótola PV, Silveira Fonseca V. Neurocisticercose gigante: diagnóstico e tratamento. Rev Assoc Med Bras. 2010 [acceso 13/08/2023];56(4):394-6. Disponible en:
https://www.scielo.br/j/ramb/a/DC5tnB4ksZ3gyKtRPpRZWKs/?format=pdf
