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Clinical Images  |   July 2011
Extraparenchymal Neurocysticercosis
Author Notes
  • From the Department of Ophthalmology (Dr Eakle) and the Department of Medicine's Division of Infectious Diseases (Dr Wright) at the University of Kentucky College of Medicine in Lexington. 
  • Address correspondence to William F. Wright, DO, MPH, Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, University of Maryland Medical Center, 725 W Lombard St, N156, Baltimore, MD 21201-1009. E-mail: wwright@ihv.umaryland.edu 
Article Information
Imaging / Neuromusculoskeletal Disorders / Clinical Images
Clinical Images   |   July 2011
Extraparenchymal Neurocysticercosis
The Journal of the American Osteopathic Association, July 2011, Vol. 111, 451. doi:10.7556/jaoa.2011.111.7.451
The Journal of the American Osteopathic Association, July 2011, Vol. 111, 451. doi:10.7556/jaoa.2011.111.7.451
A 33-year-old Mexican man living in central Kentucky had a history of recurrent headaches, nausea, vomiting, and visual disturbances. The patient had a history of headaches with hydrocephalus diagnosed 4 years earlier with placement of a left-sided occipital ventricular peritoneal shunt. On examination, he had bilateral papilledema and neck stiffness. Results of magnetic resonance imaging of the brain demonstrated a heterogeneous cystic lesion filling the third cerebral ventricle with extension to the left interventricular foramen (also known as the foramen of Monro). The serum white blood cell count was normal with an absolute eosinophil count of less than 600 cells/μL. A screening serum IgG enzyme immunoassay for cysticercosis revealed a titer greater than 1:32, and a confirmatory cerebrospinal fluid IgG Western blot analysis was positive for at least 1 glycoprotein to Taenia solium. The ventricular peritoneal shunt was removed and an external left-sided occipital drain was placed. The patient was treated with albendazole (15 mg per kilogram of body weight twice daily) and dexamethasone (2 mg per day) for 1 month with substantial clinical and radiologic improvement. 
 The above item is the inaugural publication of “Clinical Images,” the newest section of JAOA—The Journal of the American Osteopathic Association. This section will showcase images of common medical conditions that osteopathic physicians encounter and will provide meaningful learning opportunities. Each installment of “Clinical Images” will comprise 1 or 2 medical images and a brief description of both the presentation and resolution of the condition. Authors interested in contributing to “Clinical Images” should refer to the JAOA's “Information for Contributors” at http://www.jaoa.org/misc/ifora.shtml. Submissions should be sent to jaoa@osteopathic.org
 
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