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Age: 44

Sex: Male

Indication: Headache

Save ("V")

Case #33


Findings

  • Global ventriculomegaly with asymmetric enlargement of the left lateral ventricle
  • FLAIR signal hyperintensity in bilateral parietal and occipital sulci
  • Multiple small, rounded T2 hyperintense lesions involving the brain parenchyma and subarachnoid spaces with largest lesions in the right subinsular region, ventral left thalamus, left perimesencephalic cistern, and within the bilateral sylvian fissures. A few of these lesions have peripheral enhancement and a few have associated susceptibility artifact
  • No brain parenchymal edema or significant mass effect
  • No evidence of acute infarct or hemorrhage


Diagnosis

  • Neurocysticercosis

Sample Report

Global ventriculomegaly concerning for communicating hydrocephalus. Asymmetric enlargement of the left lateral ventricle could represent a component of superimposed obstructive hydrocephalus, though an obstructing lesion is not identified at the left Foramen of Monro.

Multiple small, rounded T2 hyperintense lesions involving the brain parenchyma and subarachnoid spaces a few of which have associated peripheral enhancement and susceptibility artifact. This appearance is most typical for neurocysticercosis.

FLAIR signal hyperintensity in bilateral parietal and occipital sulci may represent meningitis related to neurocysticercosis, though there is no accompanying leptomeningeal enhancement.

No brain parenchymal edema or significant mass effect. No evidence of acute infarct or hemorrhage.


Discussion

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Images

Neurocysticercosis with cysts of varying stages including a cyst in the left perimesencephalic cistern in the vesicular stage (red arrows) and a cyst in the right subinsular region in the calcified nodular stage (yellow arrow).



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