Lateral Ventricle Neurocysticercosis: A Systematic Review of Case Reports and Case Series.

Abstract

Purpose: We performed a literature review focusing on case reports and case series studies, aiming to better define the clinical presentation of isolated lateral intraventricular neurocysticercosis (LVNCC) and to discuss the current knowledge of its characteristics, patient demographics, clinical manifestations, treatment, and prognosis, based on the collected data. Methods: Data for this study were gathered by conducting searches on the Medline database and Google Scholar using various combinations of the following terms "intraventricular neurocysticercosis (IVNCC)," "brain ventricle cyst," "cysticercosis of lateral brain ventricles," "cysticercus cyst in brain ventricles," and "intraventricular cystic brain lesion." Articles published in English between January 1980 and March 2023 that reported cases of LVNCC were selected for analysis. Results: This study included 48 patients (mean age 33.1 ± 14.1, range 6-70 years) diagnosed with LVNCC. Most patients were from India. The predominant clinical manifestation was headache (87.8%), followed by nausea/vomiting (51.2%), altered sensorium (51.2%), and focal neurological deficits (29.3%). In most cases, symptoms lasted from 10 d to 20 years (67.6%). The mean age at symptom onset was higher than in those with cysts in the third and fourth ventricles (p = 0.010058), and a greater proportion of vesicular cysts was observed (58.3%). Hydrocephalus was common (81.3%), with a significant percentage showing unilateral ventricular enlargement (38.5%). Surgical excision of the parasite (predominantly endoscopic) was the prevailing type of treatment (72.9%). Postoperatively, anti-helminthics were administered in 37.5% of cases. Most patients (80.5%) had favorable clinical outcomes or improved clinical status; six patients died, while the clinical outcomes of seven individuals were not specified in reports. Conclusion: LVNCC is a rare form of NCC, typically characterized by symptoms lasting >7 d. Invasion of the ventricle by cysticerci occurs mainly in middle-aged individuals. Endoscopy is the preferred treatment option, although the prognosis is influenced by various factors. Mortality is high in untreated patients.