Volume 98, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Ventricular involvement in neurocysticercosis (NCC), a common serious manifestation of NCC, has distinct clinical presentations, complications, and treatments primarily because of partial or complete obstruction of the cerebrospinal fluid (CSF) flow by cysts. We review the clinical course, treatments, and long-term outcomes in 23 of 121 (19.0%) total NCC patients with ventricular cysts referred to the National Institutes of Health from 1985 to the October 2017. Patients had a median age of 31.8 (range: 22.4–52.6 years), were 60.9% male, diagnosed a median of 6.5 years (range: 0.17–16 years) after immigration, and were followed for a median of 3.6 years (range: 0.1–30.5 years). Other forms and manifestations of NCC were present in 73.9% (17/23). The fourth ventricle was involved in a majority (15/23, 65.2%) resulting in hydrocephalus (73.9%), ventriculitis, and periventricular edema (7/23, 30.4%). Cystectomy was accomplished in 60.9%, usually by removal of a fourth ventricular cyst through a suboccipital craniotomy. Nonresectable cysts were treated medically. Ventriculoperitoneal shunts were inserted in 43.5% (10/23) and failed in four, three from infection. Other complications included surgically induced injuries (4/23, 17.4%) and entrapment of a lateral ventricle (2/23, 8.7%). Despite a common severe early course, 90.9% (20/22) stabilized without recurrence, 15% (3/20) complained of mild-to-moderate neurological complaints, and 15% (3/20) were significantly disabled. Four patients who underwent removal of ventricular cysts without significant other NCC and who received with no cysticidal treatment became CSF cestode antigen negative without recurrence indicating that after successful extraction of cysts, additional cysticidal treatment may not be needed.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Garcia HH, Nash TE, Del Brutto OH, , 2014. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 13: 12021215. [Google Scholar]
  2. Apuzzo ML, Dobkin WR, Zee CS, Chan JC, Giannotta SL, Weiss MH, , 1984. Surgical considerations in treatment of intraventricular cysticercosis. An analysis of 45 cases. J Neurosurg 60: 400407. [Google Scholar]
  3. Cuetter AC, Andrews RJ, , 2002. Intraventricular neurocysticercosis: 18 consecutive patients and review of the literature. Neurosurg Focus 12: e5. [Google Scholar]
  4. Madrazo I, Garcia RJ, Sandoval M, Lopez VF, , 1983. Intraventricular cysticercosis. Neurosurgery 12: 148152. [Google Scholar]
  5. Sinha S, Sharma BS, , 2012. Intraventricular neurocysticercosis: a review of current status and management issues. Br J Neurosurg 26: 305309. [Google Scholar]
  6. Citow JS, Johnson JP, McBride DQ, Ammirati M, , 2002. Imaging features and surgery-related outcomes in intraventricular neurocysticercosis. Neurosurg Focus 12: e6. [Google Scholar]
  7. Colli BO, Martelli N, Assirati Júnior JA, Machado HR, Salvarani CP, Sassoli VP, Forjaz SV, , 1994. Cysticercosis of the central nervous system. I. Surgical treatment of cerebral cysticercosis: a 23 years experience in the Hospital das Clinicas of Ribeirao Preto Medical School. Arq Neuropsiquiatr 52: 166186. [Google Scholar]
  8. Colli BO, Pereira CU, Assirati Júnior JA, Machado HR, , 1993. Isolated fourth ventricle in neurocysticercosis: pathophysiology, diagnosis, and treatment. Surg Neurol 39: 305310. [Google Scholar]
  9. DeFeo D, Foltz EL, Hamilton AE, , 1975. Double compartment hydrocephalus in a patient with cysticercosis meningitis. Surg Neurol 4: 247251. [Google Scholar]
  10. Bergsneider M, , 1999. Endoscopic removal of cysticercal cysts within the fourth ventricle. Technical note. J Neurosurg 91: 340345. [Google Scholar]
  11. Neal JH, , 1995. An endoscopic approach to cysticercosis cysts of the posterior third ventricle. Neurosurgery 36: 10401043. [Google Scholar]
  12. Del Brutto OH, 2001. Proposed diagnostic criteria for neurocysticercosis. Neurology 57: 177183. [Google Scholar]
  13. Dorny P, Vercammen F, Brandt J, Vansteenkiste W, Berkvens D, Geerts S, , 2000. Sero-epidemiological study of Taenia saginata cysticercosis in Belgian cattle. Vet Parasitol 88: 4349. [Google Scholar]
  14. Nash TE, Ware JM, Mahanty S, , 2017. Natural history of patients with perilesional edema around Taenia solium calcified granulomas. J Infect Dis 215: 11411147. [Google Scholar]
  15. Martinez HR, Rangel-Guerra R, Arredondo-Estrada JH, Marfil A, Onofre J, , 1995. Medical and surgical treatment in neurocysticercosis a magnetic resonance study of 161 cases. J Neurol Sci 130: 2534. [Google Scholar]
  16. Serpa JA, Graviss EA, Kass JS, White AC, Jr., 2011. Neurocysticercosis in Houston, Texas: an update. Medicine (Baltimore) 90: 8186. [Google Scholar]
  17. Marcin Sierra M, 2017. Extraparenchymal neurocysticercosis: demographic, clinicoradiological, and inflammatory features. PLoS Negl Trop Dis 11: e0005646. [Google Scholar]
  18. McCormick GF, Zee CS, Heiden J, , 1982. Cysticercosis cerebri. Review of 127 cases. Arch Neurol 39: 534539. [Google Scholar]
  19. Dixon HBF, Lipscomb FM, , 1961. Cysticercosis: An Analysis and Follow Up of 450 Cases. Medical Council Special Report Series, No. 299. London, United Kingdom: Her Majesty’s Stationary Office, 1–58.
  20. Stern WE, , 1981. Neurosurgical considerations of cysticercosis of the central nervous system. J Neurosurg 55: 382389. [Google Scholar]
  21. Torres-Corzo JG, Tapia-Perez JH, Vecchia RR, Chalita-Williams JC, Sanchez-Aguilar M, Sanchez-Rodriguez JJ, , 2010. Endoscopic management of hydrocephalus due to neurocysticercosis. Clin Neurol Neurosurg 112: 1116. [Google Scholar]
  22. Goel RK, Ahmad FU, Vellimana AK, Suri A, Chandra PS, Kumar R, Sharma BS, Mahapatra AK, , 2008. Endoscopic management of intraventricular neurocysticercosis. J Clin Neurosci 15: 10961101. [Google Scholar]
  23. Proano JV, Torres-Corzo J, Rodriguez-Della Vecchia R, Guizar-Sahagun G, Rangel-Castilla L, , 2009. Intraventricular and subarachnoid basal cisterns neurocysticercosis: a comparative study between traditional treatment versus neuroendoscopic surgery. Childs Nerv Syst 25: 14671475. [Google Scholar]
  24. Rajshekhar V, , 2010. Surgical management of neurocysticercosis. Int J Surg 8: 100104. [Google Scholar]
  25. Khade P, Lemos RS, Toussaint LG, , 2013. What is the utility of postoperative antihelminthic therapy after resection for intraventricular neurocysticercosis? World Neurosurg 79: 558567. [Google Scholar]
  26. Proano JV, Madrazo I, Garcia L, Garcia TE, Correa D, , 1997. Albendazole and praziquantel treatment in neurocysticercosis of the fourth ventricle. J Neurosurg 87: 2933. [Google Scholar]
  27. Mitre E, Talaat KR, Sperling MR, Nash TE, , 2007. Methotrexate as a corticosteroid-sparing agent in complicated neurocysticercosis. Clin Infect Dis 44: 549553. [Google Scholar]

Data & Media loading...

  • Received : 30 Jan 2018
  • Accepted : 01 Mar 2018
  • Published online : 23 Apr 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error