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    Go to the top of the page   ID: 20090428145402 Original case in german  More links about this topic on Pubmed (PubMed Reader)
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    Neurocysticercosis
    Sanjeeb Kumar. Neurocysticercosis. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090428145402


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Sanjeeb Kumar Sarma (Down Town Hospital/ Guwahati/ India)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    6 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    inflammatory or infectious  

     
     Pediatric Radiology CasesHistory: *

    A 6 year old female child presented with history of three episodes of seizure in last fifteen days. No complains other than that.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease : *

    Neurocysticercosis (NCC) is caused by larval form of pork intestinal tapeworm Taenia Solium. Humans are definitive host. NCC is the most common parasitic infection worldwide. It is endemic in Asia, Africa, Eastern Europe and Latin America. The general autopsy incidence of cysticercosis in those countries is approximately 4%.
    CNS infections occur in 60-90% cases of patients with cysticercosis. Brain parenchyma is the most commonly affected site. Corticomedullary junction is the primary location. Intraventricular cysticercosis cysts are seen in 20-50% cases with 4th ventricle a common site. Only 10% cases of NCC have isolated subarachnoid disease.
    Morbidity with NCC results from dead larvae that typically incite an intense host inflammatory response. NCC has broad spectrum clinical manifestations. Epilepsy is the most frequent symptom and is seen in 50-70% cases.
    Pathologically parenchymal cysticercosis has been classified into four stages: vesicular, vesicular colloidal, granular nodular and nodular calcified. Patients may have multiple lesions at different stages.
    Vesicular stage: During this stage cysticercus consists of thin capsule that surrounds a viable larva and its fluid containing bladder. There is no inflammatory reaction seen in this stage. Edema and contrast enhancements are rare in this stage.
    Colloidal vesicular stage: In this stage larva dies and degenerate. Cystic fluid becomes turbid and the cyst shrinks as its capsule thickens. Inflammatory response present and edema is seen. Ring like contrast enhancement is seen. MRI scans shows hyperintense cystic fluid compared to CSF at this stage.
    Granular nodular: At this stage cyst retracts, its capsules thickens and scolex calcifies which is seen well in CT scan. Perilesional edema is still present and ring enhancement is seen. At this stage the cyst is typically isointense on T1WI and hypointense on T2WI. The present case is in this stage.
    Nodular calcified: At this stage size retracts and totally calcified. CT scan shows calcification better than MR.
    The patient recovers completely with medication.  

     
     Pediatric Radiology CasesRadiological findings: *


    MRI 1 <- view MRI 1

    MRI 1: Axial T1WI showing only the subtle hypointensity in the right high parietal region.





    MRI 2 <- view MRI 2

    MRI 2: Axial T2WI showing 4 mm sized hypointense lesion with surrounding edema in right high parietal region.





    MRI 3 <- view MRI 3

    MRI 3: Coronal T2WI showing the same lesion in right high parietal region.





    MRI 4 <- view MRI 4

    MRI 4: Axial FLAIR image showing features similar to T2WI





    MRI 5 <- view MRI 5

    MRI 5: Axial contrast scan showing ring like enhancement with central hypointensity.





    MRI 6 <- view MRI 6

    MRI 6: Coronal contrast scan showing the same lesion





    MRI 7 <- view MRI 7

    MRI 7: Sagittal contrast scan showing the same lesion in the corticomedullary junction of right high parietal region.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Imaging including endoscopy  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings: *

    Developmental or post traumatic cyst, Cystic tumor etc.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other : *

    Prognosis is excellent. Complete cure is seen with the use of antihelminth drugs  

     
     Pediatric Radiology CasesComments of the author about the case: *

    Plain CT scan done previously could not pick up the lesion. Follow up scan after treatment reveals absolutely normal MR scan.  

     
     Pediatric Radiology CasesFirst description / History: *

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Christopher M. DeGiorgio, Marco T. Medina, Reyna Durón et al
    Neurocysticercosis
    Epilepsy Curr. 2004 May; 4(3): 107–111.

    Diagnostic Neuroradiology by Anne G. Osborn (Mosby)- chapter 16- Infection of the Brain and its linings P- 709-712.  

     
     Pediatric Radiology CasesKeywords: *

    Neurocysticercosis, taenia solium, larva, brain, human, definitive host, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Sanjeeb Kumar. Neurocysticercosis. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090428145402  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: inflammatory or infectious
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   

    Thanks to Martina Paetzel, M.D. for translating this case!

     
    Neurocysticercosis
    Sanjeeb Kumar. Neurocysticercosis. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090428145402


     

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    Neurocysticercosis
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   

    Neurocysticercosis  
     
    Neurocysticercosis
    Sanjeeb Kumar. Neurocysticercosis. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090428145402


     
     
    Neurocysticercosis
    Sanjeeb Kumar. Neurocysticercosis. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090428145402


     

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    Neurocysticercosis
    Sanjeeb Kumar. Neurocysticercosis. PedRad [serial online] vol 9, no. 4.
    URL: www.PedRad.info/?search=20090428145402


     




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