27 year old male patient presented with history of seizures.
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Post contrast T1W images demonstrate multiple well defined cystic lesions involving the right frontal, insular and left parietal and temporal lobe measuring up to 9 mm. The cyst in the left temporal region demonstrates rim enhancement and perilesional oedema suggestive of the colloid vesicular stage of neurocysticercosis with scolex showing T1W hyperintense signal. The remainder of the cystic lesions are smaller in size with minimal rim enhancement and no perilesional oedema, this is consistent with the granular nodular stage of neurocysticercosis.
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This case demonstrates two stages of neurocysticercosis, namely, colloid vesicular and granular nodular stages. The colloid vesicular stage is the most symptomatic one in which the cyst membrane becomes leaky resulting in surrounding inflammatory reactions and pericystic oedema.