Abstract
BackgroundIntraspinal 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 presentationA 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.ConclusionIsolated 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.
Highlights
Intraspinal neurocysticercosis is an uncommon manifestation that may present as an isolated lesion
Isolated spinal neurocysticercosis should be considered in the differential diagnosis of acute hydrocephalus when no explanation is found in the brain, in geographical regions endemic for cysticercosis
Neurocysticercosis (NCC) of the central nervous system is classified by location as parenchymal, subarachnoid, intraventricular, or spinal
Summary
Cysticercosis is a common parasitic disease that invades the central nervous system; in humans, this condition is caused by encysted larvae of Taenia solium. Acute hydrocephalus due to isolated spinal NCC is extremely rare because most patients with spinal NCC present evidence of cerebral disease [4]. We report a rare case of isolated intraspinal NCC exhibiting clinical features of acute hydrocephalus. Case presentation A 64-year-old man was admitted to our institute with a history of severe headache, an unsteady gait, and occasional urinary incontinence. These symptoms began 2 days prior to admission, and the patient had previously been healthy without medical concerns. After the 6-month follow-up period, these symptoms remained, and the patient was unable to ambulate without assistance despite improvements in ventricular dilation (Figure 3)
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