Intradural-extramedullary spinal cysticercosis without parenchymal involvement

Background: Neurocysticercosis is being encountered with increasing frequency in non-endemic areas. The disease has a broad variety of clinical and radiographic presentations that can make the diagnosis a challenge for clinicians.
Case Report: A 31-year-old male presented with chronic headaches and blurry vision. A computed-tomography scan of the head showed marked hydrocephalous and cerebral spinal fluid (CSF) analysis revealed a mild pleocytosis with eosinophilia. Subsequent magnetic resonance imaging (MRI) demonstrated an isolated intradural-extramedullary cyst in the cervical region without evidence of intraparenchymal involvement. CSF serology confirmed the diagnosis of neurocysticercosis. This represented an extremely rare presentation of neurocysticercosis that has few reports in the literature.
Conclusions: Neurocysticercosis should be included in the differential diagnosis of any patient found to have eosinophilic meningitis or who presents with unexplained seizures. A thorough understanding of the variable radiographic presentations of neurocysticercosis is required in order to effectively diagnose
this increasingly common disease.

Keywords: neurocysticersosis, eosinophilic meningitis, hydrocephalous