1/120. neurocysticercosis without detectable specific antibody. A 19-year-old girl who had lived in india for five years until 1992 was admitted to Hokuto Hospital after general seizures which lasted for fifteen minutes. Cerebral magnetic resonance imaging (MRI) showed a ring-enhanced lesion of 6 mm in diameter in the right parietal lobe. She underwent surgical resection after diagnosis of the brain tumor. Histopathological examinations revealed that the resected tumor was a cysticercus of taenia solium (T. solium), and we concluded that her seizures were caused by neurocysticercosis. Serological examinations by enzyme-linked immunosorbent assay (ELISA) and immunoblots to detect specific antibody against the glycoproteins of T. solium showed no detectable antibody response. The patient is under careful observation in our out-patient clinic with no medication. ( info) |
2/120. Parenchymatous cerebral neurocysticercosis in a quadriplegic patient. OBJECTIVE: To present and discuss a case of cerebral neurocysticercosis in a quadriplegic patient. DESIGN: Case report of a case of neurocysticercosis in a high level spinal cord injury (SCI) patient who developed episodes of autonomic dysreflexia and orthostatic hypotension associated with transient neurologic deficits and seizures. SETTING: spinal cord Unit of the University Hospital of Geneva, switzerland. SUBJECT: Single patient case report. MAIN OUTCOME MEASURE: Clinical and radiological magnetic resonance imaging follow-up of the patient between July 1995 and October 1997. RESULTS: Treatment of cysticercosis with praziquantel relieved the patient from autonomic dysreflexia, symptomatic orthostatic hypotension, transitory neurological deficits and seizures. CONCLUSION: diagnosis of neurocysticercosis in a quadriplegic patient might be difficult because of frequent overlaps with some usual symptoms occurring in high level SCI, mostly autonomic dysreflexia and orthostatic hypotension. neurocysticercosis should be kept in mind when a SCI patient living in, or coming from endemic zones presents with new neurological abnormalities and seizures. magnetic resonance imaging appears to be more sensitive than computerised tomography to confirm the diagnosis of active cysticercosis. Treatment with praziquantel associated with cimetidine to increase the drug bioavailability and prednisone to reduce the inflammatory reaction gives good results. ( info) |
3/120. Endoscopic removal of a third ventricular cysticercal cyst. We report the case of a young man who presented with acute obstructive hydrocephalus previously treated with bilateral ventriculo-peritoneal shunts. Previous magnetic resonance imaging studies were consistent with aqueduct stenosis; no intraventricular pathology was identified. neuroendoscopy was performed in order the third ventricle and perform a third ventriculostomy. This revealed a cysticercal lesion of the third ventricle which was removed endoscopically. In addition, a third ventriculostomy was performed and both shunt systems removed. Following a course of albendazole the patient went on to make a full recovery, and currently remains shunt independent. ( info) |
| neurocysticercosis is rarely reported in short-term travelers, although the disease remains a major public health problem in tropical regions. We present a case of neurocysticercosis that was probably acquired by ingestion of taenia solium eggs contained in the stomach of a pig butchered by the traveler. Complete clinical resolution was obtained by medical treatment, underlying the importance of early suspicion and diagnosis of the disease. ( info) |
5/120. A case of neurocysticercosis-differential diagnostic aspects. neurocysticercosis is no medical rarity but in non-endemic countries especially, a high degree of physician awareness is necessary for diagnosis. The case of a German female patient who had focal seizures for the first time at the age of 23 caused by a cerebral cyst of cysticercus cellulosae is presented. Only surgical removal and subsequent histological examination allowed diagnosis while diagnostic investigation yielded no pathological findings. ( info) |
6/120. Reappearing CT lesions: 4 cases. An overwhelming majority of disappearing CT lesions in india have been aetiologically linked to cysticercosis. We report 4 patients with disappearing CT lesions in whom the lesion later reappeared at the same (3 patients) or different site (1 patient). One patient was a Taenia carrier. Serial MRI evaluation in one patient revealed a persisting lesion in the interval period. The contribution of these observations towards the understanding of the aetiology of disappearing CT lesions is discussed. ( info) |
7/120. Reactivation of neurocysticercosis: case report. A 37-year-old woman with a known history of longstanding neurocysticercosis presented with a three-day history of new onset headache. Several years prior to her current presentation, she had undergone cysticidal treatment and was assumed to be cured of active disease. Computed tomography and magnetic resonance imaging studies done three months prior to presentation showed multiple intracerebral calcified lesions consistent with resolved neurocysticercosis. Physical and laboratory findings were noncontributory. Imaging studies showed the same previously calcified lesions, but they were now surrounded by large amounts of edema. This case represents a unique report of reactivation of neurocysticercosis and raises interesting questions about the natural history of this infection. ( info) |
8/120. Instructive case report. A 26-year-old Indian woman with seizures and multiple intracranial mass lesions. We describe the case of a 26-year-old Indian woman who presented to our institution with seizures and papilledema. Her diagnosis was originally thought to be neurocysticercosis, but later confirmed to be intracranial tuberculoma. Antituberculous therapy with isoniazid, rifampin, pyrazinamide and ethambutol was initiated. Improvement in the patient's neurological symptoms with diminution in size of the intracerebral lesions was observed. This case illustrates the difficulty in distinguishing intracranial tuberculoma from neurocysticercosis. Radiological features that distinguish these two diseases are described. Both diseases must be considered in regions endemic for tuberculosis and cysticercosis. ( info) |
9/120. Intradural-extramedullary spinal cysticercosis: MR imaging findings. A rare case with intradural-extramedullary cysticercosis is presented here. MR imaging with and without gd-DTPA were performed. There were multiple cysts in the basal cistern, cisterna magna, and cervical subarachnoid space which were isointense with cerebrospinal fluid both on T2- and T1-weighted images. Swelling and increased signal intensity in the cord parenchyma were detected on T2-weighted images. gadolinium enhanced studies showed rim-shaped enhancement in the cysts and irregular, diffuse enhancement in the meninges. ( info) |
10/120. Extradural haematoma complicating lumbar puncture following a craniotomy. A case report. BACKGROUND: This case report illustrates the development of an intracranial extradural haematoma (EDH) as an uncommon complication of a lumbar puncture. CLINICAL PRESENTATION: A 10-year-old girl operated for intra-third ventricular cysticercosis developed postlumbar puncture headache after a drainage lumbar puncture (LP) on the 7th postoperative day. CT scan revealed a right frontal EDH away from the operative site. INTERVENTION: The child was managed conservatively in view of her preserved sensorium. RESULTS: The child had an uneventful recovery. Follow-up CT scans showed resolution of the haematoma. CONCLUSIONS: LP, though considered to be a safe procedure, may rarely be associated with a potentially lethal intracranial haematoma, which can be managed successfully if diagnosed at an early stage. ( info) |