Neurocysticercosis and hydrocephalus: the value of ventriculoperitoneal shunting in its management

Author:

Cruz Lya1,Pacheco Edgar1,Soto Walter1,Cong Roberto1,Suastegui Roberto2,Moreno-Jimenez Sergio3,Fleury Agnès14ORCID

Affiliation:

1. Research Unit on Neuroinflammation, Departamento de Medicina Genomica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas – Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía , Insurgentes sur 3877, Tlalpan, 14269, México City , México

2. Epilepsy Clinic, Instituto Nacional de Neurología y Neurocirugía , Insurgentes sur 3877, Tlalpan, 14269, México City , México

3. Neurosurgery Department, Instituto Nacional de Neurología y Neurocirugía , Insurgentes sur 3877, Tlalpan, 14269, México City , México

4. Neurocysticercosis clinic, Instituto Nacional de Neurología y Neurocirugía , Insurgentes sur 3877, Tlalpan, 14269, México City , México

Abstract

ABSTRACT Background Hydrocephalus is the main complication of extraparenchymal neurocysticercosis (EP-NC). Its symptomatic management relies mainly on the placement of a ventriculoperitoneal shunt (VPS). Previous studies have shown that this surgical procedure is associated with a poor prognosis, but current information is lacking. Methods We included 108 patients with a definitive diagnosis of EP-NC and hydrocephalus requiring VPS placement. We evaluated their demographic, clinical, and inflammatory characteristics, as well as the frequency of complications related to VPS placement. Results Hydrocephalus was present at the time of NC diagnosis in 79.6% of patients. VPS dysfunction occurred in 48 patients (44.4%), mainly within the first year after placement (66.7%). The dysfunctions were not associated with the location of the cyst, the inflammatory characteristics of the cerebrospinal fluid or the administration of cysticidal treatment. They were significantly more frequent in patients in whom the decision to place a VPS was made in the emergency department. Two years after VPS, patients’ Karnofsky score averaged 84.6±15 and only one patient died of a cause directly related to VPS. Conclusions This study confirmed the utility of VPS and showed a significant improvement in the prognosis of patients requiring VPS compared with previous studies.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine,Parasitology

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