1921
Volume 80, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Neurocysticercosis (NCC) includes a wide spectrum of illnesses. Newer neurosurgical approaches are being applied to NCC. Although clinical trials are leading to a consensus on medical management, fewer data address neurosurgical approaches. We reviewed all neurocysticercosis patients evaluated by neurosurgery at Ben Taub General Hospital, Houston, Texas, between August 1997 and December 2005. From 31 patients that had a neurosurgical evaluation, 16 patients were treated with shunts (5 had shunt failure requiring revision), 13 by surgical resection of cysts (9 underwent craniotomy and 4 endoscopy), and 2 by medical therapy. A fifth endoscopy was performed in one patient with shunt failure. None of the endoscopic patients needed another intervention. Despite the availability of anti-parasitic and anti-inflammatory therapies, neurosurgery continues to play an important role in the management of selected cases of NCC. In contrast to the high rate of shunt failure, neuroendoscopy seems to be associated with higher success rate than any other neurosurgical approach.

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/content/journals/10.4269/ajtmh.2009.80.373
2009-03-01
2017-09-23
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References

  1. Medina MT, Duron RM, Martinez L, Osorio JR, Estrada AL, Zuniga C, Cartagena D, Collins JS, Holden KR, 2005. Prevalence, incidence, and etiology of epilepsies in rural Honduras: the Salama Study. Epilepsia 46 : 124–131.
  2. Montano SM, Villaran MV, Ylquimiche L, Figueroa JJ, Rodriguez S, Bautista CT, Gonzalez AE, Tsang VC, Gilman RH, Garcia HH, 2005. Neurocysticercosis: association between seizures, serology, and brain CT in rural Peru. Neurology 65 : 229–233.
  3. Rajshekhar V, Raghava MV, Prabhakaran V, Oommen A, Muliyil J, 2006. Active epilepsy as an index of burden of neurocysticercosis in Vellore district, India. Neurology 67 : 2135–2139.
  4. Phiri IK, Ngowi H, Afonso S, Matenga E, Boa M, Mukaratirwa S, Githigia S, Saimo M, Sikasunge C, Maingi N, Lubega GW, Kassuku A, Michael L, Siziya S, Krecek RC, Noormahomed E, Vilhena M, Dorny P, Willingham AL 3rd, 2003. The emergence of Taenia solium cysticercosis in Eastern and Southern Africa as a serious agricultural problem and public health risk. Acta Trop 87 : 13–23.
  5. Nash TE, Singh G, White AC, Rajshekhar V, Loeb JA, Proano JV, Takayanagui OM, Gonzalez AE, Butman JA, DeGiorgio C, Del Brutto OH, Delgado-Escueta A, Evans CA, Gilman RH, Martinez SM, Medina MT, Pretell EJ, Teale J, Garcia HH, 2006. Treatment of neurocysticercosis: current status and future research needs. Neurology 67 : 1120–1127.
  6. Garcia HH, Evans CA, Nash TE, Takayanagui OM, White AC Jr, Botero D, Rajshekhar V, Tsang VC, Schantz PM, Allan JC, Flisser A, Correa D, Sarti E, Friedland JS, Martinez SM, Gonzalez AE, Gilman RH, Del Brutto OH, 2002. Current consensus guidelines for treatment of neurocysticercosis. Clin Microbiol Rev 15 : 747–756.
  7. Perez-Lopez C, Isla-Guerrero A, Alvarez F, Budke M, Fernandez-Miranda JC, Paz JF, Perez-Alvarez M, 2003. [Update in neurocysticercosis treatment]. Rev Neurol 36 : 805–811.
  8. Carpio A, 2002. Neurocysticercosis: an update. Lancet Infect Dis 2 : 751–762.
  9. Garcia HH, Pretell EJ, Gilman RH, Martinez SM, Moulton LH, Del Brutto OH, Herrera G, Evans CA, Gonzalez AE, 2004. A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med 350 : 249–258.
  10. Garg RK, 2001. Medical management of neurocysticercosis. Neurol India 49 : 329–337.
  11. Del Brutto OH, Roos KL, Coffey CS, Garcia HH, 2006. Meta-analysis: cysticidal drugs for neurocysticercosis: albendazole and praziquantel. Ann Intern Med 145 : 43–51.
  12. Serpa JA, Moran A, Goodman JC, Giordano TP, White AC Jr, 2007. Neurocysticercosis in the HIV era: a case report and review of the literature. Am J Trop Med Hyg 77 : 113–117.
  13. Monteiro L, Almeida-Pinto J, Stocker A, Sampaio-Silva M, 1993. Active neurocysticercosis, parenchymal and extraparenchymal: a study of 38 patients. J Neurol 241 : 15–21.
  14. Bandres JC, White AC Jr, Samo T, Murphy EC, Harris RL, 1992. Extraparenchymal neurocysticercosis: report of five cases and review of management. Clin Infect Dis 15 : 799–811.
  15. Proano JV, Madrazo I, Avelar F, Lopez-Felix B, Diaz G, Grijalva I, 2001. Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts. N Engl J Med 345 : 879–885.
  16. Proano JV, Madrazo I, Garcia L, Garcia-Torres E, Correa D, 1997. Albendazole and praziquantel treatment in neurocysticercosis of the fourth ventricle. J Neurosurg 87 : 29–33.
  17. Bergsneider M, Holly LT, Lee JH, King WA, Frazee JG, 2000. Endoscopic management of cysticercal cysts within the lateral and third ventricles. J Neurosurg 92 : 14–23.
  18. Chavarria A, Fleury A, Garcia E, Marquez C, Fragoso G, Sciutto E, 2005. Relationship between the clinical heterogeneity of neurocysticercosis and the immune-inflammatory profiles. Clin Immunol 116 : 271–278.
  19. Mitre E, Talaat KR, Sperling MR, Nash TE, 2007. Methotrexate as a corticosteroid-sparing agent in complicated neurocysticercosis. Clin Infect Dis 44 : 549–553.
  20. Garcia HH, Del Brutto OH, Nash TE, White AC Jr, Tsang VC, Gilman RH, 2005. New concepts in the diagnosis and management of neurocysticercosis (Taenia solium). Am J Trop Med Hyg 72 : 3–9.
  21. Colli BO, Carlotti CG Jr, Assirati JA Jr, Machado HR, Valenca M, Amato MC, 2002. Surgical treatment of cerebral cysticercosis: long-term results and prognostic factors. Neurosurg Focus 12 : e3.
  22. Kelley R, Duong DH, Locke GE, 2002. Characteristics of ventricular shunt malfunctions among patients with neurocysticercosis. Neurosurgery 50 : 757–761.
  23. Husain M, Jha DK, Rastogi M, Husain N, Gupta RK, 2007. Neuro-endoscopic management of intraventricular neurocysticercosis (NCC). Acta Neurochir (Wien) 149 : 341–346.
  24. Martinez HR, Rangel-Guerra R, Arredondo-Estrada JH, Marfil A, Onofre J, 1995. Medical and surgical treatment in neuro-cysticercosis a magnetic resonance study of 161 cases. J Neurol Sci 130 : 25–34.
  25. Mazza M, Di Rienzo A, Costagliola C, Roncone R, Casacchia M, Ricci A, Galzio RJ, 2004. The interhemispheric transcallosal-transversal approach to the lesions of the anterior and middle third ventricle: surgical validity and neuropsychological evaluation of the outcome. Brain Cogn 55 : 525–534.
  26. Kasowski HJ, Nahed BV, Piepmeier JM, 2005. Transcallosal transchoroidal approach to tumors of the third ventricle. Neurosurgery 57 : 361–366.
  27. Torres-Corzo J, Rodriguez-della Vecchia R, Rangel-Castilla L, 2006. Bruns syndrome caused by intraventricular neurocysticercosis treated using flexible endoscopy. J Neurosurg 104 : 746–748.
  28. Feng H, Huang G, Liao X, Fu K, Tan H, Pu H, Cheng Y, Liu W, Zhao D, 2004. Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis. J Neurosurg 100 : 626–633.
  29. Husain M, Rastogi M, Jha DK, Husain N, Gupta RK, 2007. Endoscopic transaqueductal removal of fourth ventricular neurocysticercosis with an angiographic catheter. Neurosurgery 60 : 249–254.
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Supplementary Data

Endoscopic Extraction of Intraventricular Neurocysticercosis - video clip

  • Received : 29 Aug 2008
  • Accepted : 01 Nov 2008

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