Cerebral Endoscopy in Hydrocephalus Secondary to Neurocysticercosis

Abstract

Neurocysticercosis (NCC) is a common parasite affecting the central nervous system, causing over 50,000 fatalities annually in Latin America. Treatment varies depending on the location and prognosis is not good. Treatment often involves anti-parasitic medications and shunt implantation. Meningitis, stroke, and hydrocephalus are common complications. Endoscopy is the primary treatment for ventricular forms, but alternative methods like shunt implantation and microsurgery are considered. Anti-cysticercus medications and shunt implantation are recommended for patients with subarachnoid forms and hydrocephalus.

Endoscopy is a potential treatment for extra-parenchymal NCC due to its potential to reduce inflammation and improve cerebrospinal fluid (CSF) circulation. However, early extraction may reduce the risk of chronic inflammation. Patients without extracorporeal membranes (ETV) have a higher shunt failure rate, potentially due to tolerance to changes in CSF flow. The Karnofsky index, an estimate used to evaluate functional status, suggests that endoscopy as an initial therapy is a viable option. Patients with a history of shunting or chronic illness may benefit from a comprehensive examination of the ventricular system and basal subarachnoid space. Steroid administration is recommended after treatment to prevent parasitic antigen release and immune response.