Contemporary neurosurgical approaches to neurocysticercosis.
Neurocysticercosis (NCC) includes a wide spectrum of illnesses. Newer neurosurgical approaches are being applied to NCC. Although clinical trials are leading to a consensus on medical management, fewer data address neurosurgical approaches. We reviewed all neurocysticercosis patients evaluated by neurosurgery at Ben Taub General Hospital, Houston, Texas, between August 1997 and December 2005. From 31 patients that had a neurosurgical evaluation, 16 patients were treated with shunts (5 had shunt failure requiring revision), 13 by surgical resection of cysts (9 underwent craniotomy and 4 endoscopy), and 2 by medical therapy. A fifth endoscopy was performed in one patient with shunt failure. None of the endoscopic patients needed another intervention. Despite the availability of anti-parasitic and anti-inflammatory therapies, neurosurgery continues to play an important role in the management of selected cases of NCC. In contrast to the high rate of shunt failure, neuroendoscopy seems to be associated with higher success rate than any other neurosurgical approach.
Rangel-Castilla
Leonardo
L
Division of Neurosurgery, University of Texas Medical Branch, Galveston, Texas 77555-0517, USA. lerangel@utmb.edu
Serpa
Jose A
JA
Gopinath
Shankar P
SP
Graviss
Edward A
EA
Diaz-Marchan
Pedro
P
White
A Clinton
AC
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000977:Antiparasitic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D000977:Antiparasitic Agents