METHODS: This case report discusses a patient with obstructive hydrocephalus and eosinophilic meningitis secondary to racemose NCC. The diagnosis process was initially complicated by the patient\'s history of pork allergy and absence of radiographic evidence of helminthic CNS infection. Further investigation showed a 4th ventricle multi-cystic lesion causing hydrocephalus which prompted a surgical intervention with a ventriculoperitoneal shunt (VPS) in conjunction with anti-helminthic medical treatment. At 1-year follow-up, the patient has reported recurrence of VPS related complications.
UNASSIGNED: Larval cysts typically deposit within the brain parenchyma, making them easily detected on head computed tomography (CT) scans and leading to neurologic sequelae such as epilepsy. In this case, the absence of CT evidence of NCC and the patient\'s lifelong history of pork allergy slowed the diagnosis process.
CONCLUSIONS: Racemose NCC is a rare subset of the disease in which cyst clusters occupy the extra parenchymal space, thereby changing the symptomatic profile and making the cysts more difficult to visualize in imaging studies. In this case, magnetic resonance imaging (MRI) was the best imaging modality to diagnosis extra parenchymal NCC and guide its surgical management.
方法:本病例报告讨论1例梗阻性脑积水和嗜酸性粒细胞性脑膜炎继发于总状NCC。最初,由于患者的猪肉过敏史和缺乏蠕虫中枢神经系统感染的影像学证据,诊断过程变得复杂。进一步的调查显示,第四脑室多囊性病变导致脑积水,这促使采用脑室腹膜分流术(VPS)结合抗蠕虫药物治疗进行手术干预。在1年的随访中,患者报告VPS相关并发症复发.
■幼虫囊肿通常沉积在脑实质内,使它们容易在头部计算机断层扫描(CT)扫描中检测到,并导致神经系统后遗症,如癫痫。在这种情况下,无CT证据的NCC和患者的终身猪肉过敏史减缓了诊断过程.
结论:总状花序性NCC是一种罕见的疾病子集,其中囊肿簇占据实质外间隙,从而改变症状的轮廓,使囊肿在影像学研究中更难以可视化。在这种情况下,磁共振成像(MRI)是诊断实质外NCC并指导其手术治疗的最佳成像方式。