DOI  10.17613/jav3-s538 

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Case Report

Treatment of Triventricular Hydrocephalus Secondary to Neurocysticercosis: A Case Report and Literature Review.

Juan Carlos García Aquino*a, Diana Díaz Gonzálezb, Mauricio Garcia Aquinoc , Guillermo Luna Álvarezd, Gabriel Herrera Armendárize.

a. Third-year Neurosurgery Resident, Institute for Social Security and Services for State Workers (ISSSTE), Puebla, Mexico. jcaquino@outlook.com, https://orcid.org/0009-0004-8249-2949. [Corresponding author]

b. Medical Intern, National Cancer Institute (INCAN), Mexico City, Mexico. diana.diaz02@upaep.edu.mx, https://orcid.org/0009-0003-2358-1338.

c. Social Service Medical Intern. Santa Inés del Monte, Oaxaca. maurigarcia-69@outlook.com, https://orcid.org/0009-0005-7368-5738.

d. Attending Neurosurgeon, Institute for Social Security and Services for State Workers (ISSSTE), Puebla, Mexico. neurolunadr@gmail.com, https://orcid.org/0009-0004-0437-9756.

e. Attending Neurosurgeon, Institute for Social Security and Services for State Workers (ISSSTE), Puebla, Mexico. drherreraneuro@gmail.com, https://orcid.org/0000-0003-1419-6510.

KEYWORDS: Neurocysticercosis, Hydrocephalus, Endoscopic Third Ventriculostomy, Cerebellopontine Angle.

ABSTRACT:
Objective: To present the case of a 53-year-old patient with extraparenchymal neurocysticercosis. Symptoms, diagnosis, and treatment via endoscopic third ventriculostomy (ETV) are detailed, thereby enhancing the understanding of this rare clinical manifestation and contributing knowledge regarding the effectiveness of surgical intervention in similar scenarios.

Case report: A 53-year-old male with no relevant medical history. In 2021, he began experiencing headache and vertigo, for which he received symptomatic treatment without relief. By April 2023, after undergoing multiple treatments, his symptoms persisted. In August of the same year, he developed bilateral lower extremity paresis (4/5 on the Daniels scale), urinary incontinence, bradypsychia, and short-term memory disturbances, prompting referral to the neurosurgery department.

Conclusion: The high effectiveness of endoscopic third ventriculostomy in the treatment of triventricular hydrocephalus caused by neurocysticercosis is emphasized. The decision to use ETV was based on the Endoscopic Third Ventriculostomy Success Score (ETVSS), which has proven effective in adult patients. The combination of ETV with a right retrosigmoid approach enabled the removal of previously non-visible cysts, significantly contributing to the patient's clinical improvement. In the context of subarachnoid neurocysticercosis, where cyst removal is crucial, minimally invasive techniques such as endoscopic surgery not only allow effective removal but also minimize and eliminate the inherent risks of open procedures.

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