title: Endoscopic scoring system for extraparenchymal neurocysticercosis.
abstract: OBJECTIVE
  To propose a scoring system using endoscopy for assessment of the inflammatory alterations caused by neurocysticercosis (NCC) inside the ventricular cavities and the basal subarachnoid space.
  
  
  METHODS
  Video recordings of the endoscopic procedures in patients with hydrocephalus secondary to NCC were assessed in a two-phase study. In the first phase (n = 10), the assigned score of each patient was correlated with the cerebrospinal fluid values obtained by lumbar and ventricular puncture. Reproducibility was determined using an intraclass correlation coefficient. In the second phase (n = 30), the prognostic value of the score was tested by comparing it with the patient's Karnofsky performance score (KPS) 3 months after endoscopy.
  
  
  RESULTS
  The score included four main components: ependymal findings, number of involved sites, abnormalities in the subarachnoid space, and other alterations. These values were summed to produce a total score, which correlated strongly with both protein and cell counts from ventricular cerebrospinal fluid. The intraclass correlation coefficient of the global score was 0.85. In the second phase, the scores were divided into mild, moderate, and severe categories (6, 15, and 9 patients). The initial KPS was similar between the groups (P = 0.56); however, when measured 3 months later, there were significant differences (P = 0.02). The logistic regression analysis of patients with a score in the severe range (odds ratio = 0.09; 95% confidence interval, 0.06-0.64) showed a reduced chance for achieving a good outcome (KPS ≥90) after 3 months.
  
  
  CONCLUSIONS
  Our scoring system enables endoscopic classification of the damage caused by NCC in the ventricular and basal subarachnoid space. The score has a biologic basis and a good internal reproducibility. The score seems to be useful for determining the short-term prognosis, and patients with high scores require additional therapeutic measures to improve their outcomes.
authors.affiliation: Department of Neurosurgery, Hospital Central Dr Ignacio Morones Prieto, San Luis Potosí, México.
authors.forename: J Humberto
authors.initials: JH
authors.lastname: Tapia-Pérez
authors.forename: Jaime G
authors.initials: JG
authors.lastname: Torres-Corzo
authors.forename: Juan C
authors.initials: JC
authors.lastname: Chalita-Williams
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodríguez-Della Vecchia
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Sánchez-Rodríguez
authors.forename: Martín
authors.initials: M
authors.lastname: Sánchez-Aguilar
mesh_terms: D002552:Cerebral Ventricles / Q000473:pathology; D015331:Cohort Studies; D004724:Endoscopy; D006801:Humans; D006849:Hydrocephalus / Q000469:parasitology / Q000473:pathology* / Q000601:surgery; D020019:Neurocysticercosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013346:Subarachnoid Space / Q000473:pathology