Hemorrhagic Cerebrovascular Events and Neurocysticercosis: A Case Report and Review of the Literature

George M. Viola Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas; The University of Texas, MD Anderson Cancer Center, Houston, Texas; Division of Infectious Diseases, University of Texas Medical Branch at Galveston, Texas

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A. Clinton White Jr. Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas; The University of Texas, MD Anderson Cancer Center, Houston, Texas; Division of Infectious Diseases, University of Texas Medical Branch at Galveston, Texas

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Jose A. Serpa Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas; The University of Texas, MD Anderson Cancer Center, Houston, Texas; Division of Infectious Diseases, University of Texas Medical Branch at Galveston, Texas

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Cerebrovascular complications have been reported to occur in patients with neurocysticercosis (NCC). We report a patient who presented with relapsed subarachnoid hemorrhage possibly linked to NCC. In addition, we performed a literature review of all of the reported cases of aneurysmal and non-aneurysmal hemorrhagic cerebrovascular events associated with NCC. We identified 11 such cases. The majority of the individuals were young males (mean: 38 years; 70% males). Four cases (36%) had aneurysms. Four (36%) others had negative cerebral angiograms and therefore classified as non-aneurysmal, while the remaining three (28%) did not report sufficient information to classify them. All cases with aneurysmal hemorrhage underwent successful surgical repair of the aneurysms. Seven patients received albendazole (including three who had had surgery). Three patients died; all three presented in the pre-albendazole era. In summary, neurocysticercosis should be considered in the differential diagnosis of hemorrhagic cerebrovascular events in young patients without classical vascular risk factors who have lived or visited NCC-endemic areas.

Author Notes

*Address correspondence to Jose A. Serpa, Baylor College of Medicine, Department of Medicine, Section of Infectious Diseases, One Baylor Plaza, BCM 286, Room N1319, Houston, TX 77030. E-mail: jaserpaa@bcm.edu

Authors' addresses: George M. Viola, The University of Texas MD Anderson Cancer Center, Department of Medicine, Division of Infectious Diseases, Infection Control and Employee Health, Houston, TX, E-mail: GMViola@mdanderson.org. A. Clinton White Jr., Director, Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, E-mail: acwhite@utmb.edu. Jose A. Serpa, Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, E-mail: jaserpaa@bcm.edu.

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