Intraventricular and subarachnoid racemose cysticercosis
A 40-year-old male patient presented with complaint of occipital headache for 2 months. There was no associated history of nausea or vomiting. There was no history of seizures, visual symptoms or altered behavior. There was no history of hypertension or diabetes. Neurological examination did not reveal any focal deficit. Cranial nerves were normal on examination. Cerebrospinal fluid (CSF) examination was normal. Initially, plain CT scan was done. It revealed asymmetrical enlargement of ventricular system. No focal parenchymal lesions were seen. Subsequently, MR imaging of brain with contrast was done on 1.5 T scanner. Axial T1W [], post contrast sagittal [] and post contrast coronal [] images revealed multiple cystic lesions of varying sizes in the subarachnoid spaces and in intraventricular location. Cyst walls were not well seen on T2W images []. No enhancement was seen. No scolex was indentified in the lesions. Largest of them was seen in left temporal horn. There was evidence of hydrocephalus with asymmetrical dilatation of lateral ventricles, which could be attributed to similar cysts in lateral ventricles whose walls may not be discernible on MRI. Third and fourth ventricles were normal in caliber. Based on the characteristic imaging findings, diagnosis of intraventricular and subarachnoid racemose cysticercosis was made. Due to widespread lesions and non-specific symptoms, the patient was managed conservatively.