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The rolling cyst: migrating intraventricular neurocysticercosis—a case-based update

Abstract

Background

Neurocysticercosis is the most frequent parasitic disease of the central nervous system, and its incidence in the developed countries is increasing due to immigration and travels from endemic areas. The intraventricular location has been found to involve up to 61.3% of the patients; moreover, only 22 cases of migrating intraventricular cyst have been reported so far. Despite the rarity of the condition in western countries, its occurrence generates some concerns and the aim of this paper is to update the information concerning pathogenesis, clinical presentation, diagnosis and management of this entity.

Methods and results

All the pertinent literature was analysed, focused on the cases of migrating intraventricular neurocysticercosis and its peculiar features. An illustrative case regarding a 14-year-old girl is also presented.

Conclusions

Migrating intraventricular neurocysticercosis is a pathognomonic entity usually presenting with hydrocephalus, and its treatment is mainly surgical, preferring an endoscopic approach. When the resection of the intraventricular cyst is not performed, an accurate follow-up is mandatory to detect clinical changes due to a recurrent hydrocephalus or to the effect of the dying cyst on the surrounding area. In case of permanent shunt placement, the cysticidal and steroid treatment is recommended to reduce the risk of shunt failure.

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Abbreviations

CISS:

Constructive interference in steady-state

CSF:

Cerebrospinal fluid

CT:

Computed tomography

ETV:

Endoscopic third ventriculostomy

EVD:

External ventricular drain

FIESTA:

Fast imaging employing steady-state acquisition

GCS:

Glasgow Coma Scale

ICP:

Intracranial pressure

MRI:

Magnetic resonance imaging

VPS:

Ventriculoperitoneal shunt

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Correspondence to Valentina Baro.

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Baro, V., Anglani, M., Martinolli, F. et al. The rolling cyst: migrating intraventricular neurocysticercosis—a case-based update. Childs Nerv Syst (2020). https://doi.org/10.1007/s00381-020-04505-w

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Keywords

  • Neurocysticercosis
  • Ventricular cyst
  • Migrating cyst
  • Hydrocephalus