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    T2-fluid attenuated inversion recovery magnetic resonance imaging (transverse section) of the patient, showing a free-floating Taenia solium cyst (arrow) in the right occipital horn of the lateral ventricle (supine position).

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    Repeat T2-fluid attenuated inversion recovery magnetic resonance imaging of the patient in a prone position, showing a Taenia solium cyst (arrowhead) shifting anteriolaterally to the base of the lateral ventricle.

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    T1-magnetic resonance imaging (sagittal section) of the patient, showing a Taenia solium cyst (*) partially occluding the third ventricle.

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    Larval stage of Taenia solium removed from the right lateral ventricle of the patient by neuroendoscopic surgery.

  • 1.

    Citow JS, Johnson P, McBride DQ, Ammirati M, 2002. Imaging features and surgery-related outcomes in intraventricular neurocysticercosis. Neurosurg Focus 12: e6.

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    • Export Citation
  • 2.

    Rajshekhar V, 2010. Surgical management of neurocysticercosis. Int J Surg 8: 100104.

 

 

 

 

Positional Headaches in a Young Brazilian Woman

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  • Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York; Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru

A 26-year-old Brazil-born woman was hospitalized because of severe headaches that increased in severity when she moved her head. T2-fluid attenuated inversion recovery magnetic resonance imaging showed a cystic-like lesion in the right occipital horn of the lateral ventricle (Figure 1). Repeat magnetic resonance imaging of a ventral decubitus position showed that the free-floating cyst shifted anteriolaterally to the base of the lateral ventricle (Figure 2) and partially occluded the interventricular foramen (Figure 3). Enzyme-linked immunosorbent assay identified IgG against Taenia solium cysticercosis in cerebrospinal fluid and serum samples.

Figure 1.
Figure 1.

T2-fluid attenuated inversion recovery magnetic resonance imaging (transverse section) of the patient, showing a free-floating Taenia solium cyst (arrow) in the right occipital horn of the lateral ventricle (supine position).

Citation: The American Society of Tropical Medicine and Hygiene 87, 5; 10.4269/ajtmh.2012.12-0270

Figure 2.
Figure 2.

Repeat T2-fluid attenuated inversion recovery magnetic resonance imaging of the patient in a prone position, showing a Taenia solium cyst (arrowhead) shifting anteriolaterally to the base of the lateral ventricle.

Citation: The American Society of Tropical Medicine and Hygiene 87, 5; 10.4269/ajtmh.2012.12-0270

Figure 3.
Figure 3.

T1-magnetic resonance imaging (sagittal section) of the patient, showing a Taenia solium cyst (*) partially occluding the third ventricle.

Citation: The American Society of Tropical Medicine and Hygiene 87, 5; 10.4269/ajtmh.2012.12-0270

She underwent uneventful neuroendoscopic removal of a 1.3-cm cyst (Figure 4) that was histologically compatible with a T. solium larval stage infection. Positional headaches, a characteristic feature of spontaneous intracranial hypotension, cluster headaches, and various brain tumors such as colloid cysts, are commonly self-reported by patients with intraventricular neurocysticercosis. Infections with this parasite result in partial and temporary cerebrospinal fluid obstruction of the ventricular system.1 Neuroendoscopic removal has been performed in persons with intraventricular neurocysticercosis and shows minimal perioperative complications,2 such as in our patient.

Figure 4.
Figure 4.

Larval stage of Taenia solium removed from the right lateral ventricle of the patient by neuroendoscopic surgery.

Citation: The American Society of Tropical Medicine and Hygiene 87, 5; 10.4269/ajtmh.2012.12-0270

  • 1.

    Citow JS, Johnson P, McBride DQ, Ammirati M, 2002. Imaging features and surgery-related outcomes in intraventricular neurocysticercosis. Neurosurg Focus 12: e6.

    • Search Google Scholar
    • Export Citation
  • 2.

    Rajshekhar V, 2010. Surgical management of neurocysticercosis. Int J Surg 8: 100104.

Author Notes

* Address correspondence to Vicente Maco, Division of Infectious Diseases, Beth Israel Medical Center, Albert Einstein College of Medicine, 1st Avenue at 16th Street, New York, NY 10003. E-mail: vicente_maco@hotmail.com

Authors' addresses: Vicente Maco, Division of Infectious Diseases, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY, and Institute of Tropical Medicine, Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru, E-mail: vicente_maco@hotmail.com. Jose A. Cortes, Division of Infectious Diseases, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY, E-mail: jcortes@chpnet.org.

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