Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM 87108, USA.
J Neuroimaging. 2011 Jan;21(1):38-43. doi: 10.1111/j.1552-6569.2009.00452.x.
neurocysticercosis (NCC) prevalence is increasing throughout the United States mainly because of immigration from Latin America. Clinicians may fail to recognize the extraparenchymal disease because they do not consider the diagnosis.
to analyze neuroimaging and clinical characteristics of extraparenchymal NCC, we retrospectively reviewed all such cases presenting to a major general medical school hospital in the State of New Mexico.
eleven (30%) of our 37 cases of NCC diagnosed using standard criteria from 1998 through 2004 had extraparenchymal disease. On neuroimaging, 36% of the patients lacked parenchymal cysts, 64% had intraventricular cysticerci, 64% had subarachnoid cysticerci, and 64% had hydrocephalus due to either basal arachnoiditis or direct obstruction of intraventricular pathways. Lumbar puncture was performed in 6 patients. All had a cerebrospinal fluid (CSF) pleocytosis, none had CSF or blood eosinophilia, and CSF antibody to NCC could be absent while present in serum. Response to treatment was frequently suboptimal.
extraparenchymal NCC is more frequent than previously thought. Because clinicians outside the Southwest United States are often unfamiliar with NCC as a cause of chronic meningitis, chronic ventriculitis, or hydrocephalus without obvious cysts, the diagnosis of extraparenchymal NCC often depends on the correct interpretation of neuroimaging.
神经囊虫病（NCC）在美国的发病率正在上升，主要是因为来自拉丁美洲的移民。临床医生可能因为没有考虑到这种诊断而未能识别出脑外疾病。
为了分析脑外 NCC 的神经影像学和临床特征，我们回顾性地分析了在新墨西哥州的一所主要综合医学院附属医院就诊的所有此类病例。
在 1998 年至 2004 年期间，根据标准标准诊断出的 37 例 NCC 中，有 11 例（30％）患有脑外疾病。在神经影像学上，36％的患者缺乏实质囊肿，64％的患者有脑室囊虫，64％的患者有蛛网膜下腔囊虫，64％的患者因基底蛛网膜炎或脑室途径直接阻塞而出现脑积水。对 6 例患者进行了腰椎穿刺。所有患者的脑脊液（CSF）均有白细胞增多，无 CSF 或血液嗜酸粒细胞增多，而 CSF 对 NCC 的抗体可能在血清中存在而缺失。治疗反应经常不理想。
脑外 NCC 比以前认为的更为常见。由于美国西南部以外的临床医生通常不熟悉 NCC 是慢性脑膜炎、慢性脑室炎或无明显囊肿的脑积水的原因，因此脑外 NCC 的诊断通常取决于对神经影像学的正确解释。
