Ramesh Devika, Maurya Dilip K, Gopalakrishnan Madhavan S, Pegu Bhabani, Ananthakrishnan Ramesh, Nair Pradeep P, Keepanasseril Anish
Department of Obstetrics and Gynaecology, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, India.
Department of Neurosurgery, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, India.
Obstet Med. 2021 Mar;14(1):57-61. doi: 10.1177/1753495X20904895. Epub 2020 Mar 18.
The diagnosis of neurocysticercosis in pregnancy is challenging, even in endemic areas, as other neurological conditions with similar manifestations are common. Obstetricians and physicians may be reluctant to do neuroimaging in pregnancy and often the availability is limited in endemic areas. Management of neurocysticercosis depends on the symptomatology. In those presenting with features of increased intracranial pressure early treatment is necessary, taking into consideration the gestational age and the maternal condition at presentation. Presence of intraventricular cysts causing obstructive hydrocephalus necessitates their removal due to the risk of intracranial hypertension which could be life-threatening, particularly peripartum. We report a case of a woman with intraventricular neurocysticercosis, who presented in the third trimester, and described the management dilemmas that were encountered. The differential diagnoses and other aspects of the medical and surgical management of neurocysticercosis in pregnancy are also discussed.
妊娠期神经囊尾蚴病的诊断具有挑战性，即使在流行地区也是如此，因为具有相似表现的其他神经系统疾病很常见。产科医生和内科医生可能不愿在妊娠期进行神经影像学检查，而且在流行地区这种检查的可及性通常有限。神经囊尾蚴病的治疗取决于症状。对于那些早期出现颅内压升高特征的患者，需要尽早治疗，同时要考虑孕周和就诊时的母体状况。由于存在导致梗阻性脑积水的脑室内囊肿，因其有引发颅内高压的风险，而颅内高压可能危及生命，尤其是在围产期，所以需要将其清除。我们报告了一例在孕晚期出现脑室内神经囊尾蚴病的女性病例，并描述了所遇到的治疗困境。还讨论了妊娠期神经囊尾蚴病的鉴别诊断以及药物和手术治疗的其他方面。
