Neuro-endoscopic management of intraventricular neurocysticercosis (NCC).
OBJECTIVE
Various approaches including endoscopy have been used for the treatment of intraventricular and cisternal NCC. We present our technique of Neuro-endoscopic management of intraventricular NCC.


METHODS
Twenty-one cases, 13 females and 8 males (age range 12-50 years; mean, 25.7 years), of intraventricular NCC [lateral (n = 6), third (n = 6), fourth (n = 10) ventricles including a patient with both lateral and third ventricular cysts] producing obstructive hydrocephalus formed the group of study. Gaab Universal Endoscope System along with 4 mm 0 degrees and 30 degrees rigid telescopes were used through a frontal burr-hole for removal of intraventricular including intra-fourth ventricular (n = 10) NCC. Endoscopic third ventriculostomy (ETV) was done for internal cerebrospinal fluid (CSF) diversion. Average follow up was 18 months.


RESULTS
Complete (n = 18) or partial (n = 2) removal of NCC was done in 20 patients, while a cyst located at foramen of Monro slipped and migrated to occipital or temporal horn in 1 patient. Thirty-degree 4-mm rigid telescope provided excellent image quality with ability to address even intra-fourth ventricular NCC through the dilated aqueduct using a curved tip catheter. No patient required further surgery for their hydrocephalus. There was no operative complication and post-operative ventriculitis was not seen in any case despite partial removal of NCC.


CONCLUSIONS
Neuro-endoscopic surgery is an effective treatment modality for patients with intraventricular NCC. It effectively restores CSF flow and is capable of removing cysts completely or partially from accessible locations causing mass effect. Partial removal or rupture of the cyst does not affect the clinical outcome of the patients.
Husain
M
M
Department of Neurosurgery, King George's Medical University, Lucknow, India. mazharhusain@hotmail.com
Jha
D K
DK
Rastogi
M
M
Husain
N
N
Gupta
R K
RK
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000469:parasitology / Q000473:pathology / Q000601:surgery; D002552:Cerebral Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002555:Cerebrospinal Fluid / Q000502:physiology; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005260:Female; D020546:Fourth Ventricle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D020547:Lateral Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020542:Third Ventricle / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000295:instrumentation / Q000379:methods*