Awake surgery for isolated parenchymal degenerating neurocysticercosis – Case report and focused review of misdiagnosis of neurocysticercosis

Awake surgery for isolated parenchymal degenerating neurocysticercosis – Case report and focused review of misdiagnosis of neurocysticercosis

Differential diagnosis of isolated single neurocysticercosis can be difficult, and management is controversial. We report here an original surgical strategy, and review previous studies reporting misdiagnosis, using the PRISMA guidelines. A 24-year-old man was admitted to our hospital for recent mem...

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Bibliographic Details
Published in:Neuro-chirurgie Vol. 65; no. 6; pp. 402 - 416
Main Authors: Vienne, A., Dulou, R., Bielle, F., Baruteau, M., Maison, F.-L., Nikolova Yordanova, Y.
Format: Journal Article
Language:English
Published: France Elsevier Masson SAS 01-12-2019
Subjects:
Awake surgery
Brain Diseases - diagnosis
Brain Diseases - diagnostic imaging
Brain Diseases - surgery
Cystic lesion
Diagnosis, Differential
Diagnostic Errors
Differential diagnosis
Humans
Magnetic Resonance Imaging
Male
Nerve Degeneration
Neurocysticercosis
Neurocysticercosis - diagnosis
Neurocysticercosis - diagnostic imaging
Neurocysticercosis - surgery
Neurosurgical Procedures - methods
Treatment Outcome
Tuberculoma
Tumor
Wakefulness
Young Adult
Awake surgery
Tuberculoma
Tumor
Differential diagnosis
Neurocysticercosis
Cystic lesion
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Summary:Differential diagnosis of isolated single neurocysticercosis can be difficult, and management is controversial. We report here an original surgical strategy, and review previous studies reporting misdiagnosis, using the PRISMA guidelines. A 24-year-old man was admitted to our hospital for recent memory impairment, hypoesthesia of the right hand, and recurrent focal seizures without loss of consciousness. Brain MRI revealed a single ring-enhancing parenchymal lesion in the left superior postcentral gyrus, with large perilesional edema. Since exhaustive systemic exploration was negative, surgical resection of the lesion was decided on in a multidisciplinary team meeting. To preserve eloquent brain areas, surgery was performed in awake condition. It allowed complete resolution of clinical manifestations. The diagnosis of neurocysticercosis was confirmed on pathology. This case illustrates the utility of awake surgery in degenerating neurocysticercosis in functional areas, and emphasizes the importance of including it in differential diagnosis of cystic ring-enhancing brain lesions.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:0028-3770
1773-0619
DOI:10.1016/j.neuchi.2019.07.002