BrainTF29-Intraventricular Cysticercus

Clinical Profile:

Patient presented with headaches, vomiting and giddiness. 

Findings:

There is evidence of a well circumscribed lesion having a diameter of approximately 1.3 cms located in the fourth ventricle. It is near isointense to CSF with a rim that is isointense to white matter on all the pulse sequences. An eccentric nodule that is near isointense to white matter is seen in this lesion, inferiorly and to the right and may represent the scolex.  Another similar smaller lesion is seen in the left perimesencephalic cistern.

Discussion: 

Cysticercosis results from ingestion of the ova of the pork tapeworm, Taenia solium, and development of the primary oncospheres into secondary larvae, known as cysticerci, in the CNS and elsewhere.
Intracranial involvement may be:

The parenchyma is involved in more than two thirds of all cases. It occurs in the ventricles in 22% of cases. The scolex and the thin rim of the cyst wall may be visible within the apparently enlarged ventricle even though the cystic contents themselves may be indistinguishable from CSF. The cysts may be mobile and may also cause secondary obstructive hydrocephalus. When the cyst dies, it loses its immunological invisibility. The resulting inflammation leads to ependymitis. Cysticercosis also may occur in a subarachnoid location (10%), especially in the basal cisterns where sterile, racemose cysts of larger size (up to several centimeters) are common. As in the ventricles, an inflammatory response may be visible in adjacent parenchyma.

References:

  1. Chang K-H, Lee JH, Han MH, Han MC: The role of contrast-enhanced MR imaging in the diagnosis of neurocysticercosis: AJNR 1991: 128:509-512.
  2. Whiteman MLH, Bowen BC, Post MJD, Bell MD: Intracranial Infection. In: Atlas SW: Magnetic Resonance Imaging of the Brain and Spine, Lippincot-Raven, pp:757-763, Second Edition.

 

Please see:

Brain TF7
Spine TF5

 

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