Surgical case of subacute headache in a young Latin American woman

Neurocysticercosis (NCC) is the most common helmintic disease affecting the central nervous system and a major cause of adult-onset epilepsy in the developing world. 1 We describe a case of intraventricular NCC associated with hydrocephalus in a 28-year-old woman, Peruvian native, admitted to the emergency department for subacute headache and nausea. The cranial CT scan done showed asymmetric enlargement of the lateral ventricles which on cranial MRI was revealed to be due to an intraventricular cyst. An intraventricular endoscope was used to remove the cyst at the foramina of Monro, and therefore treat the obstructive hydrocephalus. NCC—a known cause of hydrocephalus in many Latin American countries—should be among the differential diagnosis in a patient with history of travel or residency in these countries. Treatment of choice for obstructive hydrocephalus caused by NCC is cyst removal with neuroendoscopy.

A NEW MULTIPURPOSE VENTRICULOSCOPE

THIS ARTICLE DESCRIBES a new multipurpose ventriculoscope that combines the advantages of several neuroendoscopic systems that are already available and provides some new features. This system can be used for all intracranial endoscopic procedures, such as endoscopic third ventriculostomy, septum fenestration, foraminoplasty, aqueductoplasty, stenting, cyst fenestrations, intraventricular tumor biopsy or resection, or intraventricular cyst or clot removal. The ventriculoscope can be used in both adults and children. Because of its diameter, it is not designed for the endoscopic treatment of newborns.

Sensory and Motor Interhemispheric Integration after Section of Different Portions of the Anterior Corpus Callosum in Nonepileptic Patients

OBJECTIVE: We evaluated somatosensory and motor interhemispheric integration in four patients who underwent transection of different portions of the anterior corpus callosum (CC) for removal of an intraventricular cyst. The study goal was to relate their performances to the topographical organization of the CC. METHODS: Experimental tasks included bimanual coordination, tactile cross-localization, and intermanual and interfield comparisons of somesthetic information. Response accuracy and response times were measured. In addition, interhemispheric transmission times were obtained in the somesthetic modality. RESULTS: Section of the middle portion of the genu caused a deficit in motor coordination, which was absent in patients with more posteriorly located lesions, whereas section of more rostral portions of the genu seemed to interfere with motor planning. The most posterior section in our sample, including the anterior portion of the body of the corpus, abolished interhemispheric transfer of simple somesthetic information (perception of touch) but not tactile discrimination (intermanual comparisons of shapes). We speculate that more complex somesthetic information is transferred through the caudal region of the body of the CC, which was spared in all patients. Thus, it seems that section of different portions of the anterior CC (genu and anterior body) produces specific deficits in interhemispheric integration in the motor and somesthetic modalities. These deficits are consistent with the anteroposterior topography of anterior callosal fibers. CONCLUSION: The specific disconnections deficits observed in this study may provide the surgeon with information regarding the consequences of anterior callosotomy and allow for remedial measures to be implemented if required.