Abstract
Neurocysticercosis is primarily managed with anthelminthic, antiepileptic, and corticosteroid therapies. Surgical removal of the larval cyst is indicated when associated mass effect causes neurological symptoms, as demonstrated in two cases. Cyst resection was achieved via the far lateral approach for a cervicomedullary cyst in one patient and via the subtemporal approach for a mesencephalic cyst in another. The cyst wall should be kept intact, when possible, to avoid dissemination of the inflammation-evoking contents. As the contents are usually semisolid and can be removed via suction, it is not necessary to remove the gliotic capsule or adherent portions of the cyst wall in highly eloquent locations.The video can be found here: https://youtu.be/GqbaJu5sy1o.
Highlights
0:20 Two cases of neurocysticercosis of the brainstem treated with microsurgical resection by the far lateral and subtemporal approaches
MRI scan of the brain disclosed an enhancing mass presenting towards the right side of the brainstem, which is seen here at the cervicomedullary junction
The surgical strategy here is to make as direct an approach as possible to the brainstem without retracting on the brainstem or on the cranial nerves
Summary
KEYWORDS brainstem; cyst; far lateral approach; inflammation; larva; neurocysticercosis; subtemporal approach; tapeworm; video 0:20 Two cases of neurocysticercosis of the brainstem treated with microsurgical resection by the far lateral and subtemporal approaches. MRI scan of the brain disclosed an enhancing mass presenting towards the right side of the brainstem, which is seen here at the cervicomedullary junction.
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