J Korean Neurosurg Soc.  2011 May;49(5):296-298. 10.3340/jkns.2011.49.5.296.

Isolated Spinal Neurocysticercosis : Unusual Ocular Presentation Mimicking Pseudotumor Cerebri

• Seo JH
• Seo HJ
• Kim SW
• Shin H

• KMID: 1442583
• DOI: http://doi.org/10.3340/jkns.2011.49.5.296

Abstract

Spinal intradural cysticercosis is a rare manifestation of neurocysticercosis. We report a unique patient who showed visual symptoms and normal imaging of the brain caused by isolated spinal neurocysticercosis. A 59-year-old male patient was admitted to the emergency unit with a history of severe headache and progressive blurred vision. Brain computed tomographic scanning and magnetic resonance imaging showed normal cerebral anatomy without hydrocephalus. The fundoscopic evaluation by an ophthalmologist showed bilateral papilledema. Perimetry studies revealed visual field defects in both eyes. With the diagnosis of pseudotumor cerebri, a lumbar tap was attempted; however, we could not drain the cerebrospinal fluid in spite of appropriate attempts. Lumbar magnetic resonance imaging revealed multilevel intraspinal lesions that were confirmed histologically to be neurocysticercosis. An intraoperative lumbar puncture revealed an increased opening pressure and cytochemical analysis showed elevated cerebrospinal fluid protein level. The headache resolved immediately after surgery. However, the visual symptoms remained and recovered only marginally despite antihelminthic medications after six months of operation.

Keyword

Spinal neurocysticercosis; Pseudotumor cerebri; Cerebrospinal spinal fluid

MeSH Terms

Brain
Cysticercosis
Emergencies
Eye
Headache
Humans
Hydrocephalus
Magnetic Resonance Imaging
Male
Middle Aged
Neurocysticercosis
Papilledema
Pseudotumor Cerebri
Spinal Puncture
Vision, Ocular
Visual Field Tests
Visual Fields