Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Isolated Spinal Neurocysticercosis : Unusual Ocular Presentation Mimicking Pseudotumor Cerebri

  • Seo, Jong-Hun (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Seo, Hong-Ju (Department of Thoracic and Cardivascular Surgery, College of Medicine, Chosun University) ;
  • Kim, Seok-Won (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Shin, Ho (Department of Neurosurgery, College of Medicine, Chosun University)
  • Received : 2010.03.22
  • Accepted : 2011.04.18
  • Published : 2011.05.28
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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.

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