• World Neurosurg · Jan 2024

    Is Anti-helminthics Necessary in Postoperative Treatment of Intraventricular Neurocysticercosis? A Systematic Review.

    • Zoran Milenković, Stefan Momčilović, Aleksandra Ignjatovic, and Suzana Tasić-Otašević.
    • General Hospital "Sava Surgery", Kej 29 decembra 2, Niš, Serbia. Electronic address: zmilenkovic3@gmail.com.
    • World Neurosurg. 2024 Jan 1; 181: e533e550e533-e550.

    ObjectivePatients with intraventricular neurocysticercosis (IVNCC) may require cerebrospinal fluid diversion surgery for late-onset hydrocephalus in the postsurgical period. Controversy exists regarding cysticidal treatment. Our main objective was to compare surgically treated cases of IVNCC that received postoperative anthelmintics with those that did not regard the incidence and treatment of late-onset hydrocephalus.MethodsWe searched the Medline database and extracted the following data: age, gender, stage of development of cysticercosis, type of operation, frequency of delayed hydrocephalus, cerebrospinal fluid diversion surgery, outcome, and follow-up.ResultsWe analyzed 130 articles on intraventricular cysticercosis and identified 117 cases of isolated IVNCC and 314 patients in the case-control series who met inclusion criteria. There was no significant difference in postoperative delayed hydrocephalus between isolated IVNCC and case-control study groups. Children under the age of 16 received anthelmintic drugs more frequently during the postoperative period. Statistical relevance was observed in all patient groups regarding the application of steroids in favor of cysticidal therapy Endoscopy was a better option than craniotomy for cases of isolated IVNCC and case-control studies. Other variables were not relevant.ConclusionsPatients who received antihelminths did not show a statistically significant reduction in delayed hydrocephalus compared to individuals who did not receive after surgical resection of the parasite. Corticosteroid therapy prevailed in people who have been treated with anthelmintics. Children under the age of 16 were administered anthelmintic drugs more frequently during the postoperative period. Endoscopy was the preferred method for all groups, but some patients with cysts in the fourth ventricle required a craniotomy.Copyright © 2023 Elsevier Inc. All rights reserved.

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