Abstract
Case reportG.F.M, 71 years old, male, farmer, presented a history of holocranial headache of a pulsatile type, more intense on waking, and associated with photophobia. The complaint lasted six months. He also reported episodes of tinnitus and unilateral hearing loss on the left. After conducting screening tests in the emergency department, communicating hydrocephalus and cystic lesions were found in the subarachnoid and intraparenchymal space. In the neurological examination, the positive data were bilateral papilledema and hearing loss in the left boné conduction. Given these findings, the racemous variant of neurocysticercosis and secondary hydrocephalus was suspected, causing intracranial hypertension. Thus, it was decided to start specific treatment with albendazole 15 mg/kg/day (two daily doses), associated with praziquantel 50 mg/kg/day (three daily doses), for 14 days. To reduce the inflammatory process of the lesions, it was proposed to keep the patient on dexamethasone 8 mg/day for 90 days. In addition to this scheme, topiramate 100 mg/day associated with acetazolamide 1 g/day was started, along with serial lumbar puncture to relieve intracranial pressure. ConclusionThe combination of modern diagnostic tests, use of antiparasitic drugs, optimization of anti-inflammatory treatments and minimally invasive neurosurgical procedures have improved results in patients with NCC. Even so, this is the helminth infection that most affects the CNS and represents a major public health problem in most parts of the world, since it remains a neglected pathology, like so many other parasites, given that it is susceptible to containment through simple preventive actions as well as eradication.
Highlights
Cysticercosis is an infection caused by the larvae of Taenia solium, which is an intestinal parasite of animals - like a pig - and has a secondary life cycle in humans
NCC is highly endemic in most low-income countries, including areas such as Latin America, African Sahara, and parts of Asia[2,3], being considered an emerging condition in developed countries in Europe, as well as in the USA and Canada, due to the migratory movements
In Latin America and the Caribbean, an estimated 75 million people are at risk of infection
Summary
From the report presented and the association between the radiological images and the presented clinical picture, the diagnosis of the racemic variant of neurocysticercosis was reached. This is the helminth infection that most affects the CNS and represents a major public health problem in most parts of the world, since it remains a neglected pathology, like so many other parasites, given that it is susceptible to containment through simple preventive actions, as well as eradication. This, in turn, depends on individualized clinical treatment, with increased time for subarachnoid cysts (mainly in the racemous variant), use of corticosteroids before and concomitant with the use of antiparasitic drugs in most cases, and use of anticonvulsants when necessary. Patrick Giordanni Gomes Sampaio https://orcid.org/0000-0003-0952-9798 Hiago Diniz Maracajá https://orcid.org/0000-0002-5032-3436 Túlio Carneiro Monteiro Temoteo https://orcid.org/0000-0001-6160-3321 Sara Raquel Nóbrega Figueiredo https://orcid.org/0000-0002-3832-4065 Francielle Lopes de Araújo Batista https://orcid.org/0000-0002-7256-4070
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