Cerebral cysticercosis manifesting as hydrocephalus--case report

Current status and perspectives of cysticercosis and taeniasis in Japan

This mini-review describes recent epidemiological trends in cysticercosis and taeniasis in Japan. Some of the topics discussed herein were presented at the first symposium on "Current perspectives of Taenia asiatica researches", that was held in Osong in Chungbuk Province, South Korea, in October 2011 and organized by Prof. K. S. Eom, Chungbuk National University School of Medicine. To better understand the trends in the occurrence of cysticercosis and taeniasis in Japan, clinical cases reported in 2005 have been updated. In addition, the current status of Taenia asiatica infections successively occurring in Japan since 2010 is also discussed.

Subarachnoid basal neurocysticercosis: a focus on the most severe form of the disease

Neurocysticercosis is an endemic disease in Latin America, Asia and Africa with growing occurrence in industrialized countries due to the increase in migration from low- and middle-income to high-income countries. The most severe clinical presentation is when the parasite is located in the subarachnoid space at the base of the brain (NCSAB). Aside from its clinical presentation, the severity of this form of the disease is due to the difficulties in diagnosis and treatment. Although NCSAB frequency is lower than that reported for the parenchymal location of the parasite, its clinical relevance must be emphasized. We provide a critical review of the central epidemiological, clinical, diagnostic and therapeutic features of this particular form of the disease, which is still associated with unacceptably high rates of morbidity and mortality.

Update on eosinophilic meningoencephalitis and its clinical relevance

Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Worm parasites enter an organism through ingestion of contaminated water or an intermediate host and can eventually affect the central nervous system (CNS). These infections are potentially serious events leading to sequelae or death, and diagnosis depends on currently limited molecular methods. Identification of parasites in fluids and tissues is rarely possible, while images and clinical examinations do not lead to a definitive diagnosis. Treatment usually requires the concomitant administration of corticoids and anthelminthic drugs, yet new compounds and their extensive and detailed clinical evaluation are much needed. Eosinophilia in fluids may be detected in other infectious and noninfectious conditions, such as neoplastic disease, drug use, and prosthesis reactions. Thus, distinctive identification of eosinophils in fluids is a necessary component in the etiologic diagnosis of CNS infections.

Endoscopic removal of cisternal neurocysticercal cysts. Technical note

The authors report the use of neuroendoscopy for the treatment of cisternal neurocysticercosis. The utilization of the endoscope is meant to provide a safe and minimally invasive procedure for the removal of symptomatic cysts, minimizing morbidity and mortality relating to the natural history of the disease, as well as possibly avoiding a more extensive standard open craniotomy. A retrospective review of three cases of cisternal cysticercosis was performed. The presenting signs and symptoms, neuroimaging findings, endoscopic treatment, and outcomes are presented. The technical aspect of the endoscopic resection is described, with visual support provided by intraoperative video. Cerebrospinal fluid shunt placement was avoided in one patient in whom complete resection of the cyst was required. In one patient there were extensive interhemispheric and premesencephalic cisternal cysts, some of which could not be removed because of their multiplicity and extensive adhesions. Despite the intraoperative rupture of cysts, there were no cases of arachnoiditis or ventriculitis postoperatively. The minimally invasive endoscopic resection of cisternal cysticercosis is possible and effective in selected patients. Although the most appropriate treatment of cisternal cysticercosis remains a controversial issue, endoscopic resection should be considered as a primary treatment in symptomatic patients in cases that are amenable to endoscopic intervention.