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Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review.

Mahale RR, Mehta A, Rangasetty S - J Clin Neurol (2015)

Bottom Line: Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium.The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay.The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore, Karnataka, India. rohanmahale83@gmail.com.

ABSTRACT
Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.

No MeSH data available.


Related in: MedlinePlus

Brain fluid-attenuated inversion recovery MRI sequence showing a hypointense, lobulated cystic lesion with internal septation and without a scolex in the left temporoparietal region, causing a mass effect.
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Figure 2: Brain fluid-attenuated inversion recovery MRI sequence showing a hypointense, lobulated cystic lesion with internal septation and without a scolex in the left temporoparietal region, causing a mass effect.

Mentions: Racemose neurocysticercosis usually presents as a meningeal, intraventricular, or subarachnoid (cisternal) form (Figs. 2 and 3). The meningeal form presents with raised intracranial pressure due to various causes. It causes widespread meningitis and adhesions that result in cerebrospinal fluid (CSF) obstruction and hydrocephalus. It may subsequently cause vasculitis and entrapment of the cranial nerves in the inflammatory exudate, resulting in a focal neurological deficit.2627 Entrapment of oculomotor nerves may cause extraocular muscle paralysis and diplopia. The optic nerve and optic chiasm may become encased within the exudate, causing decreased vision and visual field defects.2829 In the intraventricular and subarachnoid (cisternal) forms, the oncospheres reach the ventricles via the choroid plexus. These parasites occlude the CSF pathway causing acute episodes of ventriculomegaly and a mass effect. Death of the larva causes ependymitis, which cause ventricular outlet obstruction and hydrocephalus.30 Patients present with raised intracranial pressure due to hydrocephalus secondary to basal meningitis and ependymitis.19 Ependymitis may cause ventricular entrapment, causing double-compartment syndrome.18


Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review.

Mahale RR, Mehta A, Rangasetty S - J Clin Neurol (2015)

Brain fluid-attenuated inversion recovery MRI sequence showing a hypointense, lobulated cystic lesion with internal septation and without a scolex in the left temporoparietal region, causing a mass effect.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507373&req=5

Figure 2: Brain fluid-attenuated inversion recovery MRI sequence showing a hypointense, lobulated cystic lesion with internal septation and without a scolex in the left temporoparietal region, causing a mass effect.
Mentions: Racemose neurocysticercosis usually presents as a meningeal, intraventricular, or subarachnoid (cisternal) form (Figs. 2 and 3). The meningeal form presents with raised intracranial pressure due to various causes. It causes widespread meningitis and adhesions that result in cerebrospinal fluid (CSF) obstruction and hydrocephalus. It may subsequently cause vasculitis and entrapment of the cranial nerves in the inflammatory exudate, resulting in a focal neurological deficit.2627 Entrapment of oculomotor nerves may cause extraocular muscle paralysis and diplopia. The optic nerve and optic chiasm may become encased within the exudate, causing decreased vision and visual field defects.2829 In the intraventricular and subarachnoid (cisternal) forms, the oncospheres reach the ventricles via the choroid plexus. These parasites occlude the CSF pathway causing acute episodes of ventriculomegaly and a mass effect. Death of the larva causes ependymitis, which cause ventricular outlet obstruction and hydrocephalus.30 Patients present with raised intracranial pressure due to hydrocephalus secondary to basal meningitis and ependymitis.19 Ependymitis may cause ventricular entrapment, causing double-compartment syndrome.18

Bottom Line: Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium.The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay.The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, MS Ramaiah Medical College & Hospital, Bangalore, Karnataka, India. rohanmahale83@gmail.com.

ABSTRACT
Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.

No MeSH data available.


Related in: MedlinePlus