Sinha Sumit, Sharma Bhawani Shankar
Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
Br J Neurosurg. 2012 Jun;26(3):305-9. doi: 10.3109/02688697.2011.635820. Epub 2011 Dec 15.
The infection of brain and its coverings by larval stage of tapeworm Taenia solium leads to Neurocysticercosis (NCC). The intraventricular form of NCC (IVNCC) has a rapidly progressive course and seen in 15-54% cases. This demands prompt management, as the patients usually present with features of raised intracranial pressure because of cyst load or occlusion of CSF pathways due to associated ependymitis and basal arachnoiditis. The commonest site of occurrence is in fourth ventricle. Neuroimaging is mainstay of diagnosis of IVNCC. The treatment depends on clinical presentation, location within the ventricular system and evolutionary stage of parasite. However, the efficacy of antihelminthic treatment in IVNCC may require further collaborative clinical trials. The decision to operate in a viable intraventricular cyst depends on the presence of: (i) mass effect (ii) CSF obstruction (iii) fourth ventricular cysts. Recently, endoscopic approaches have been the favorable treatment option for IVNCC with hydrocephalus as the clinical results far outbetter those for open approaches used previously.
猪带绦虫幼虫阶段感染脑及其被膜会导致神经囊尾蚴病（NCC）。脑室型NCC（IVNCC）病程进展迅速，见于15% - 54%的病例。这需要及时处理，因为患者通常因囊肿负荷或由于相关室管膜炎和基底蛛网膜炎症导致脑脊液通路阻塞而出现颅内压升高的症状。最常见的发生部位是第四脑室。神经影像学是IVNCC诊断的主要手段。治疗取决于临床表现、在脑室系统内的位置以及寄生虫的演变阶段。然而，抗蠕虫治疗在IVNCC中的疗效可能需要进一步的协作临床试验。对于可行的脑室内囊肿，手术决策取决于以下情况的存在：（i）占位效应（ii）脑脊液梗阻（iii）第四脑室囊肿。近来，对于伴有脑积水的IVNCC，内镜治疗方法已成为有利的治疗选择，因为临床结果远比以前使用的开放手术方法要好得多。
