Neurocysticercosis. An imaging analysis of 35 cases.

Abstract

Neurocysticercosis (NCC) is the most frequent parasitic disease of the central nervous system. Other Portuguese works showed it to be endemic in the north of our country. The purpose of this paper is to aid the characterization of NCC in the geographic area of our Institution. We retrospectively reviewed the findings of computed tomography (CT) in 35 patients with NCC, including 23 adults and 12 children. There was no significant sex predominance in adults, however, in children the female/male ratio was 2. We found important clinical and radiological differences between adults and children. In the pediatric age group, the active forms were characteristically solitary or scarce inflammatory lesions. This radiologic picture was associated with neurologic focal signs. In these cases, a trial with anticysticercoid drugs is important to settle the diagnosis and avoid brain biopsy. Almost all of our cases (94%) were parenchymatous forms. This can be explained, in part, by the limitations of CT in the ventricular and cisternal compartments. Magnetic resonance is the ideal method in these locations. About half our patients (49%) were of African origin, most of them immigrants from the former Portuguese colonies where NCC is endemic.