Neurocysticercosis

Case contributed by RMH Report Writing

Presentation

Headache.

Patient Data

Age: 37 years
Gender: Male
CT

CT Brain

There is a small enhancing lesion in the right inferior temporal gyrus.

There is adjacent vasogenic oedema present.

No other lesions are seen elsewhere.

MRI

MRI Brain

Small probably intra-axial lesion at the right inferior temporal gyrus corresponds to the abnormality demonstrated on CT. This demonstrates peripheral low signal on all sequences. There is surrounding T2 and FLAIR hyperintensity (probably representing vasogenic oedema) and parenchymal enhancement. The suggestion of overlying leptomeningeal enhancement.

No abnormal elevation of relative cerebral blood volume (not shown).

MRS is unremarkable (not shown).

No significant mass effect.

The remainder of the brain is unremarkable.

No other lesion is demonstrated.

No abnormal diffusion restriction.

Case Discussion

Biopsy proven neurocysticercosis. The radiological features demonstrated in this case are strongly suggestive to neurocysticercosis: small cystic lesion with a scolex within. 

Remember that neurocysticercosis has four recognised stages:

  1. vesicular - visible parasite with little or no inflammation
  2. colloidal vesicular - the parasite begins to degenerate (dead) and surrounding oedema and inflammation is usually present
  3. granular nodular - scolex is mineralized, cyst walls thicken and inflammatory process decrease
  4. nodular calcified - completely mineralized with no inflammation 
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Case information

rID: 42786
Case created: 8th Feb 2016
Last edited: 18th Sep 2017
Tag: rmh
Inclusion in quiz mode: Included

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