Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 527-531
DOI: 10.4103/ajns.AJNS_112_20
Original Article

Endoscopic excision of intraventricular neurocysticercosis cyst with an angiocatheter: A retrospective analysis

Varun Aggarwal
Department of Neurosurgery, PGIMS, Rohtak, Haryana
,
Gopal Krishna
Department of Neurosurgery, PGIMS, Rohtak, Haryana
,
Ishwar Singh
Department of Neurosurgery, PGIMS, Rohtak, Haryana
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Introduction: An intraventricular cysticercus cyst is observed in 7%–30% patients of neurocysticercosis (NCC). Apart from causing arachnoiditis, intraventricular NCC (IVNCC) can cause sudden death due to acute episodes of hydrocephalus. Various treatment modalities available are external cerebrospinal fluid (CSF) diversion, microsurgical removal, and endoscopic management. There is no consensus regarding the optimal surgical treatment strategy. We are presenting our experience by doing a retrospective analysis of 26 patients having endoscopic removal of IVNCC with a rigid endoscope and angiocatheter. Aim: The aim of this study is to evaluate the results of neuroendoscopy in restoring the CSF pathway and removal of the cyst in patients of IVNCC. Materials and Methods: Retrospective analysis of clinical record and follow-up of 26 patients of IVNCC who were treated endoscopically between 2010 and 2018 was done. The diagnosis of IVNCC was made based on contrast enhanced magnetic resonance imaging of the brain. Transcranial endoscopy with 0° endoscope was performed through the frontal burr hole. Third ventriculostomy and removal of the cysticercus cyst with angiocatheter were the procedures done. Results: The success rate of intraventricular cyst excision, whether complete or partial, was 100% (14/14) in the third ventricular cyst, 62.5% (5/8) in the fourth ventricular cyst and 100% (4/4) in the lateral ventricular cyst. The overall success rate of cyst excision by endoscopy was 88.46%. The overall successful CSF flow pathway was established in 88.46% cases. The mean duration of follow-up was 44 months, and all the patients were found symptom free in the follow-up period. Conclusion: Neuroendoscopy, being a single burr hole technique successfully providing internal CSF diversion and cyst removal, is the treatment modality of choice for IVNCC.

Key-words:

Hydrocephalus - neurocysticercosis - neuroendoscopy - ventriculostomy

Financial support and sponsorship

Nil.




Publication History

Received: 25 March 2020

Accepted: 03 June 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Apuzzo ML, Dobkin WR, Zee CS, Chan JC, Giannotta SL, Weiss MH. Surgical considerations in treatment of intraventricular cysticercosis. An analysis of 45 cases. J Neurosurg 1984;60:400-7.
  • 2 Brown WJ, Voge M. Cysticercosis. A modern day plague. Pediatr Clin North Am 1985;32:953-69.
  • 3 Flisser A. Taeniasis and cysticercosis due to Taenia solium. Prog Clin Parasitol 1994;4:77-116.
  • 4 Salazar A, Sotelo J, Martinez H, Escobedo F. Differential diagnosis between ventriculitis and fourth ventricular cyst in neurocysticercosis. J Neurosurg 1983;59:660-3.
  • 5 Cuetter AC, Andrews RJ. Intraventricular neurocysticercosis: 18 consecutive patients and review of the literature. Neurosurg Focus 2002;12:e5.
  • 6 Cuetter AC, Garcia-Bobadilla J, Guerra LG, Martinez FM, Kaim B. Neurocysticercosis: Focus on intraventricular disease. Clin Infect Dis 1997;24:157-64.
  • 7 Colli BO, Martelli N, Assirati JA Jr., Machado HR, de Vergueiro Forjaz S. Results of surgical treatment of neurocysticercosis in 69 cases. J Neurosurg 1986;65:309-15.
  • 8 McCormick GF. Cysticercosis–review of 230 patients. Bull Clin Neurosci 1985;50:76-101.
  • 9 Anandh B, Mohanty A, Sampath S, Praharaj SS, Kolluri S. Endoscopic approach to intraventricular cysticercal lesions. Minim Invasive Neurosurg 2001;44:194-6.
  • 10 Cudlip SA, Wilkins PR, Marsh HT. Endoscopic removal of a third ventricular cysticercal cyst. Br J Neurosurg 1998;12:452-4.
  • 11 Husain M, Rastogi M, Jha DK, Husain N, Gupta RK. Endoscopic transaqueductal removal of fourth ventricular neurocysticercosis with an angiocatheter. Neurosurgery 2007;60:249-54.
  • 12 Psarros TG, Krumerman J, Coimbra C. Endoscopic management of supratentorial ventricular neurocysticercosis: Case series and review of the literature. Minim Invasive Neurosurg 2003;46:331-4.
  • 13 Suri A, Goel RK, Ahmad FU, Vellimana AK, Sharma BS, Mahapatra AK. Transventricular, transaqueductal scope-in-scope endoscopic excision of fourth ventricular neurocysticercosis: A series of 13 cases and a review. J Neurosurg Pediatr 2008;1:35-9.
  • 14 Citow JS, Johnson JP, McBride DQ, Ammirati M. Imaging features and surgery-related outcomes in intraventricular neurocysticercosis. Neurosurg Focus 2002;12:e6.
  • 15 Estanol B, Kleriga E, Loyo M, Mateos H, Lombardo L, Gordon F, et al. Mechanism of hydrocephalus in cerebral cysticercosis: Implications for therapy. Neurosurgery 1983;13:119-23.
  • 16 Zymberg ST, PalvaNeto MA, Gorguilo AA, Cavalheiro S. Endoscopic approach to fourth ventricular cysticercosis. Arq Neuropsiquiatr 2003;61:204-7.