title: An Unusual Presentation of Neurocysticercosis: A Space-Occupying Lesion in the Fourth Ventricle Associated with Progressive Cognitive Decline.
abstract: We communicate a case of a middle-aged Brazilian patient with an unusual presentation of fourth ventricular neurocysticercosis: occurrence of two intraventricular cysts at different locations in the brain within 2 years and cognitive decline as the only neurological symptom. Neurocysticercosis was confirmed by magnetic resonance imaging, serology, histology, and genetic analysis. Neurocysticercosis should be considered as a differential diagnosis in cases with atypical neurologic or psychiatric symptoms, atypical neuroimaging and travel history. Especially, fourth ventricular cysts carry the risk of obstructive hydrocephalus and brainstem compression and therefore should be extirpated completely. If complete removal of the cystic structures cannot be proven in cases with surgically treated neurocysticercosis, anthelminthic therapy and thorough follow-up examinations should be conducted.
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany kurz@lrz.tum.de.
authors.forename: Carolin
authors.initials: C
authors.lastname: Kurz
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Schmidt
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Poppert
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Patricia
authors.initials: P
authors.lastname: Wilkins
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: John
authors.initials: J
authors.lastname: Noh
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Poppert
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schlegel
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Claire
authors.initials: C
authors.lastname: Delbridge
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Clarissa Prazeres
authors.initials: CP
authors.lastname: da Costa
authors.affiliation: Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Germany; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; University Medical Center, Hamburg-Eppendorf, Germany; Division of Neuropathology, Institute of Pathology, Technical University Munich, Germany; Institute of Medical Microbiology, Immunology and Hygiene, Klinikum rechts der Isar, Technical University Munich, Germany.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Winkler
mesh_terms: D020546:Fourth Ventricle / Q000469:parasitology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000469:parasitology / Q000473:pathology* / Q000601:surgery