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Intraventricular and subarachnoid basal cisterns neurocysticercosis: a comparative study between traditional treatment versus neuroendoscopic surgery

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Abstract

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.

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Acknowledgments

We are indebted to Dr. Israel Grijalva for his critical reading of the manuscript and to Margarita Jimenez and Olga Elias for their invaluable assistance in the statistical analysis of the data.

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Authors and Affiliations

  1. Medical Research Unit for Neurological Diseases, Hospital de Especialidades, Centro Medico Nacional Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtémoc 330, Col. Doctores C.P., 06720, México, DF, México

    Jefferson V. Proaño & Gabriel Guizar-Sahagun

  2. Neuro Endoscopy Clinic, Department of Neurosurgery, Instituto Potosino de Neurociencias A. C. and Medical School of San Luis Potosí (SLP), San Luis Potosí, 78210, Mexico

    Jaime Torres-Corzo, Roberto Rodríguez-Della Vecchia & Leonardo Rangel-Castilla

  3. Division of Neurosurgery, University of Texas Medical Branch (UTMB), Suite 9.112, John Sealy Annex, 301 University Blvd., Galveston, TX, 77555-0517, USA

    Leonardo Rangel-Castilla

  4. Department of Neurosurgery, The Methodist Neurological Institute, The Methodist Hospital System, Houston, TX, 77030, USA

    Leonardo Rangel-Castilla

Authors
  1. Jefferson V. Proaño
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  2. Jaime Torres-Corzo
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  3. Roberto Rodríguez-Della Vecchia
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  4. Gabriel Guizar-Sahagun
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  5. Leonardo Rangel-Castilla
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Correspondence to Leonardo Rangel-Castilla.

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Proaño, J.V., Torres-Corzo, J., Rodríguez-Della Vecchia, R. et al. Intraventricular and subarachnoid basal cisterns neurocysticercosis: a comparative study between traditional treatment versus neuroendoscopic surgery. Childs Nerv Syst 25, 1467–1475 (2009). https://doi.org/10.1007/s00381-009-0933-4

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  • DOI: https://doi.org/10.1007/s00381-009-0933-4

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