title: Intraventricular migration of an isolated fourth ventricular cysticercus following cerebrospinal fluid shunting.
abstract: BACKGROUND
  Isolated intraventricular neurocysticercosis (NCC) is less frequently seen and can be missed on plain magnetic resonance imaging (MRI). Three-dimensional constructive interference in steady state (CISS) sequence is an extremely helpful sequence in identifying the lesion but is rarely used routinely.
  
  
  METHODS
  Here, we report a case of young male adult who presented with diminution of vision and headache. MRI of the brain revealed hydrocephalus, and on using CISS sequence only, the lesion could be identified in the fourth ventricle. He was treated with medical management, and ventriculoperitoneal shunting of cerebrospinal fluid was done to relieve the hydrocephalus. It resulted in immediate relief with aggravation of headache few days later. Repeat MRI revealed intraventricular migration into the left foramen of monro leading to left lateral ventricle dilatation necessitating endoscopic removal of the lesion.
  
  
  CONCLUSIONS
  CISS sequence is definitely the sequence of choice in identifying intraventricular NCC. Ventriculoperitoneal shunting can result in the intraventricular migration of the cyst due to sudden decompression necessitating repeat surgery. Endoscopic removal of NCC has a high success rate with limited complications.
authors.affiliation: Department of Radiodiagnosis, J N Medical College, Aligarh, India.
authors.forename: Saifullah
authors.initials: S
authors.lastname: Khalid
authors.affiliation: Department of Radiodiagnosis, J N Medical College, Aligarh, India.
authors.forename: Amber
authors.initials: A
authors.lastname: Obaid
authors.affiliation: Department of Neurosurgery, J N Medical College, Aligarh, India.
authors.forename: Raman M
authors.initials: RM
authors.lastname: Sharma
authors.affiliation: Department of Neurosurgery, J N Medical College, Aligarh, India.
authors.forename: Asad
authors.initials: A
authors.lastname: Mahmood
authors.affiliation: Department of Radiodiagnosis, J N Medical College, Aligarh, India.
authors.forename: Sabarish
authors.initials: S
authors.lastname: Narayanasamy
keywords: CISS sequence; VP shunting; endoscopic; intraventricular; migration; neurocysticercosis