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