Primary extensive spinal subarachnoid cysticercosis.

METHODS

A case report.

OBJECTIVE

To describe a patient with a primary extensive spinal subarachnoid cysticercosis that was successfully treated with a combination of surgical removal and albendazole.

BACKGROUND

Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system. It is mostly intracranial, but primary cysticercosis, although rare, can occur in the spinal canal. Neurological morbidity can occur if NCC is not properly treated; therefore, NCC should be considered as a lesion of primary nerve compression, which occurs within spinal canal as well as cranial cavity.

METHODS

A 48-year-old male patient presented with an 18-month history of progressive lower limb weakness and urinary incontinence. Contrast-enhanced lumbar magnetic resonance image showed multiple intradural and extramedullary masses and cysts from T12 to S1. A cervicothoracic magnetic resonance image revealed whole cervical and upper thoracic involvement. The patient was treated with a combination of surgical removal and orally administered albendazole.

RESULTS

A histopathological examination confirmed cysticercosis. After the treatment, cysticercosis had disappeared on follow-up. The patient's motor weakness in the lower limbs and urinary function were improved.

CONCLUSIONS

Spinal subarachnoid cysticercosis can occur via direct hematogenous dissemination from a gastrointestinal tract. The primary spinal cysticercosis can be dropped distantly in the spinal cavity by cerebrospinal fluid circulation like intracranial cysticercosis, and extensive spinal subarachnoid cysticercosis can be successfully treated with a combination of surgical removal and cysticidal drugs.