• World Neurosurg · Oct 2017

    Case Reports

    Primary intradural extramedullary cervical spinal cysticercosis.

    • Vetrivel Muralidharan, Bijesh Ravindran Nair, Bimal Patel, and Vedantam Rajshekhar.
    • Department of Neurological Sciences, Christian Medical College, Vellore, India.
    • World Neurosurg. 2017 Oct 1; 106: 1052.e5-1052.e11.

    BackgroundSpinal cysticercosis has been reported in 0.7%-3.0% of patients with neurocysticercosis. Most patients with spinal cysticercosis have a coexisting intracranial disease. Most often this intracranial disease manifests as intradural extramedullary lesions involving thoracic and lumbar regions or intramedullary lesions. Intradural extramedullary primary spinal cysticercosis manifesting as cervical myelopathy is extremely rare and has not been reported to date.Case DescriptionA 56-year-old man from the northeastern part of India presented with progressive spastic quadriparesis. Magnetic resonance imaging showed a ventrally located intradural extramedullary multiloculated cyst with an enhancing wall in the upper cervical region. Enzyme-linked immunoelectrotransfer blot performed to detect cysticercal antibodies in serum was positive. The patient underwent total excision of the cysts, which were confirmed histologically to be cysticercal cysts. He was also treated with 2 weeks of albendazole therapy after surgery. He had recovered fully 1 year later.ConclusionsCysticercosis should be considered in the differential diagnosis in a patient with multiloculated cysts in the spinal subarachnoid space. Surgical exploration and excision of the cysts should be performed not only to establish a diagnosis but also to decompress the cord before medical therapy.Copyright © 2017 Elsevier Inc. All rights reserved.

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