Acute hydrocephalus caused by intraspinal neurocysticercosis: case report

BMC Res Notes. 2014 Jan 2;7:2. doi: 10.1186/1756-0500-7-2.

Abstract

Background: Intraspinal neurocysticercosis is an uncommon manifestation that may present as an isolated lesion. Furthermore, acute hydrocephalus caused by isolated intraspinal neurocysticercosis without concomitant cerebral involvement is extremely rare.

Case presentation: A 64-year-old man presented with a history of severe headache, an unsteady gait, and occasional urinary incontinence. Magnetic resonance imaging of the thoraco-lumbar spine revealed multiple, cystic, contrast-enhancing intraspinal lesions. A computed tomographic scan of the brain showed marked ventricular dilatation but no intraparenchymal lesions or intraventricular cysticercal lesions. This case of acute hydrocephalus was found to be caused by isolated intraspinal neurocysticercosis and was treated by ventriculoperitoneal shunt placement and surgical removal of the intraspinal lesions (which were histologically confirmed as neurocysticercosis), followed by administration of dexamethasone and albendazole.

Conclusion: Isolated spinal neurocysticercosis should be considered in the differential diagnosis of acute hydrocephalus when no explanation is found in the brain, particularly in geographical regions endemic for cysticercosis.

Publication types

  • Case Reports

MeSH terms

  • Albendazole / therapeutic use
  • Brain Damage, Chronic / etiology
  • Combined Modality Therapy
  • Decompression, Surgical
  • Dexamethasone / therapeutic use
  • Drug Therapy, Combination
  • Gait Disorders, Neurologic / etiology
  • Headache / etiology
  • Humans
  • Hydrocephalus / etiology*
  • Hydrocephalus / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurocysticercosis / complications*
  • Neurocysticercosis / drug therapy
  • Neurocysticercosis / surgery
  • Spinal Diseases / complications*
  • Spinal Diseases / drug therapy
  • Spinal Diseases / parasitology
  • Spinal Diseases / surgery
  • Urinary Incontinence / etiology
  • Ventriculoperitoneal Shunt

Substances

  • Dexamethasone
  • Albendazole