Intraventricular and subarachnoid basal cisterns neurocysticercosis: a comparative study between traditional treatment versus neuroendoscopic surgery.
OBJECTIVE
The purpose of this study was to evaluate the efficacy of traditional treatment and minimal invasive flexible endoscopy surgery (MIFNES) in the treatment of intraventricular and subarachnoid basal cisterns neurocysticercosis (NCC).


METHODS
This was an observational comparative study of two independent series with a total of 140 patients with extremely severe forms of NCC from two different institutions. All 83 patients submitted for traditional treatment series received albendazole, and some of them received additionally praziquantel. Each cycle of both regimens lasted 4 weeks. The majority of these patients had at least one ventriculoperitoneal (VP) shunt. The rest 57 patients were submitted to the MIFNES treatment. The follow-up period was at least 6 months.


RESULTS
In all patients of both series cysticercal cysts disappeared, became calcified, or were removed. Symptoms of 136 patients improved. Four patients died. The average in the quality of life measured using the Karnofsky scale improved from a mean of 52.22 and 52.44 at the beginning to 85.48 and 90.37 at 6 months (p < 0.003), in the traditional treatment and MIFNES series, respectively. From traditional treatment, almost all patients remained with at least one VP shunt, and from the MIFNES series only 12 patients.


CONCLUSIONS
The authors postulate that MIFNES is a good alternative for the management of intraventricular and subarachnoid basal cisterns NCC because it allows removal of most of the parasites, rapid recovery of the patients, and removal and placement of shunt under direct vision when necessary. Traditional treatment is a second option where the MIFNES procedure is not available.
Proaño
Jefferson V
JV
Medical Research Unit for Neurological Diseases, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexican Institute of Social Security, 06720 México, DF, México.
Torres-Corzo
Jaime
J
Rodríguez-Della Vecchia
Roberto
R
Guizar-Sahagun
Gabriel
G
Rangel-Castilla
Leonardo
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use; D002552:Cerebral Ventricles / Q000187:drug effects / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D020019:Neurocysticercosis / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D044583:Neuroendoscopy / Q000379:methods*; D011223:Praziquantel / Q000627:therapeutic use; D011788:Quality of Life; D012189:Retrospective Studies; D013346:Subarachnoid Space / Q000187:drug effects / Q000601:surgery*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt; D055815:Young Adult
D000871:Anthelmintics; D011223:Praziquantel; D015766:Albendazole