Lines William W, Gómez-Amador Juan Luis, García Hector H, Medina Jorge E, Lira Elías, Antonio Luis A, Calderon Jose, Félix Jesús, Saavedra Luis J, Caucha Yelimer, Vásquez Carlos M
Department of Neurosurgery, Instituto Nacional de Ciencias Neurológicas, Lima, Perú.
Department of Neurological Surgery Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez," Mexico City, México.
J Neurosurg Case Lessons. 2021 Sep 6;2(10):CASE21366. doi: 10.3171/CASE21366.
Subarachnoid neurocysticercosis (NCC) is associated with high morbidity and mortality rates. Conventional transcranial approaches and transventricular endoscopy have been previously reported for extraparenchymal NCC and ventricular NCC, respectively. By October 2019, endonasal endoscopic approaches had not been used for the treatment of NCC.
A 54-year-old-woman with NCC was admitted with acute neurological deterioration due to severe intracranial hypertension caused by massive subarachnoid NCC cysts, as evidenced on magnetic resonance imaging (MRI) with great brainstem compression. The case was discussed, and an endoscopic endonasal resection of the NCC cysts was scheduled. The diagnosis was confirmed by pathological anatomy. There were no complications in the surgery, with marked neurological improvement. Control MRIs demonstrated a significant reduction of NCC cysts.
Minimally invasive approaches are an excellent alternative for skull-base tumoral and infectious pathology. Prior knowledge of the pathophysiology and the authors' experience in the management of patients with NCC allowed them to propose this approach, with optimal results.
蛛网膜下腔神经囊尾蚴病（NCC）的发病率和死亡率很高。先前已有报道，传统经颅入路和经脑室内镜检查分别用于治疗脑实质外NCC和脑室NCC。截至2019年10月，鼻内镜入路尚未用于NCC的治疗。
一名患有NCC的54岁女性因大量蛛网膜下腔NCC囊肿导致严重颅内高压而出现急性神经功能恶化入院，磁共振成像（MRI）显示脑干受压严重。对该病例进行了讨论，并计划进行鼻内镜下NCC囊肿切除术。病理解剖证实了诊断。手术无并发症，神经功能有明显改善。对照MRI显示NCC囊肿显著减少。
微创入路是治疗颅底肿瘤和感染性病变的极佳选择。对病理生理学的预先了解以及作者在NCC患者管理方面的经验使他们能够提出这种方法，并取得了最佳效果。
