J Clin Neurol.  2015 Jul;11(3):203-211. 10.3988/jcn.2015.11.3.203.

Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review

• Mahale RR
• Mehta A
• Rangasetty S

• KMID: 1894548
• DOI: http://doi.org/10.3988/jcn.2015.11.3.203

Abstract

Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.

Keyword

racemose cyst; neurocysticercosis; subarachnoid neurocysticercosis; intraventricular neurocysticercosis; cysticidal drugs; extraparenchymal

MeSH Terms

Brain
Central Nervous System
Cysticercosis
Diagnosis
Neurocysticercosis*
Neuroimaging
Taenia solium

Figure

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  Fig. 1 A: Brain fluid-attenuated inversion recovery MRI sequence showing a hypointense cystic lesion without a scolex in the right temporal lobe, causing a mass effect (arrow). B: Brain computed tomography showing a hypodense lesion in the right perisylvian region, with a mass effect.

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  Fig. 2 Brain fluid-attenuated inversion recovery MRI sequence showing a hypointense, lobulated cystic lesion with internal septation and without a scolex in the left temporoparietal region, causing a mass effect.

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  Fig. 3 Brain sagittal T2-weighted image showing a lobulated, hyperintense cystic lesion in the anterior pericallosal space and prepontine cistern (arrows).

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  Fig. 4 A: Brain coronal T1-weighted images showing a hypointense, lobulated cystic lesion with internal septation in the left Sylvian fissure (arrow). B: Brain coronal T2-weighted images showing a hyperintense, lobulated cystic lesion with internal septation in the left Sylvian fissure (arrow).

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  Fig. 5 Brain sagittal T1-weighted image showing multiple, hypointense, and cystic lesions of varying size. Some cystic lesions possess a scolex (arrow).

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  Fig. 6 Brain axial T1-weighted image showing a large, hypointense, lobulated, and cystic lesion in the right frontal lobe, causing a mass effect.

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  Fig. 7 Brain magnetic resonance imaging. Postcontrast axial T1-weighted image showing a hypointense cystic lesion with internal septations and no contrast enhancement.

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