Transventricular endoscopic approach to the anterior interhemispheric fissure for neurocysticercosis: illustrative cases

J Neurosurg Case Lessons. 2022 Oct 31;4(18):CASE22218. doi: 10.3171/CASE22218. Print 2022 Oct 31.

Abstract

Background: Neurocysticercosis (NCC) is a global public health problem. It is a complex disease to manage and a cause of great morbidity and mortality in affected patients. Conventional surgical approaches have been used for many years, but currently, minimally invasive approaches are being used with good results. The authors present a case of NCC in the anterior interhemispheric fissure that was treated with a transventricular endoscopic approach.

Observations: A 32-year-old male patient was admitted for persistent moderate headache and dizziness. Gadolinium-enhanced magnetic resonance imaging (MRI) showed multiple parenchymal, ventricular, and subarachnoid cystic lesions, especially in the anterior interhemispheric space. A transventricular endoscopic approach was selected and applied. There were no complications during surgery. Pathological analysis confirmed the diagnosis of NCC. Control MRI demonstrated the absence of cysts in the anterior interhemispheric space.

Lessons: Minimally invasive approaches are an excellent alternative for patients with NCC, especially if a patient requires more than one surgery.

Keywords: anterior interhemispheric fissure; endoscopic approach; neurocysticercosis.