Neurocysticercosis and hydrocephalus: the value of ventriculoperitoneal shunting in its management.


Journal

Transactions of the Royal Society of Tropical Medicine and Hygiene
ISSN: 1878-3503
Titre abrégé: Trans R Soc Trop Med Hyg
Pays: England
ID NLM: 7506129

Informations de publication

Date de publication:
03 Nov 2023
Historique:
received: 17 03 2023
revised: 18 04 2023
accepted: 28 04 2023
medline: 9 11 2023
pubmed: 19 5 2023
entrez: 19 5 2023
Statut: ppublish

Résumé

Hydrocephalus is the main complication of extraparenchymal neurocysticercosis (EP-NC). Its symptomatic management relies mainly on the placement of a ventriculoperitoneal shunt (VPS). Previous studies have shown that this surgical procedure is associated with a poor prognosis, but current information is lacking. We included 108 patients with a definitive diagnosis of EP-NC and hydrocephalus requiring VPS placement. We evaluated their demographic, clinical, and inflammatory characteristics, as well as the frequency of complications related to VPS placement. Hydrocephalus was present at the time of NC diagnosis in 79.6% of patients. VPS dysfunction occurred in 48 patients (44.4%), mainly within the first year after placement (66.7%). The dysfunctions were not associated with the location of the cyst, the inflammatory characteristics of the cerebrospinal fluid or the administration of cysticidal treatment. They were significantly more frequent in patients in whom the decision to place a VPS was made in the emergency department. Two years after VPS, patients' Karnofsky score averaged 84.6±15 and only one patient died of a cause directly related to VPS. This study confirmed the utility of VPS and showed a significant improvement in the prognosis of patients requiring VPS compared with previous studies.

Sections du résumé

BACKGROUND BACKGROUND
Hydrocephalus is the main complication of extraparenchymal neurocysticercosis (EP-NC). Its symptomatic management relies mainly on the placement of a ventriculoperitoneal shunt (VPS). Previous studies have shown that this surgical procedure is associated with a poor prognosis, but current information is lacking.
METHODS METHODS
We included 108 patients with a definitive diagnosis of EP-NC and hydrocephalus requiring VPS placement. We evaluated their demographic, clinical, and inflammatory characteristics, as well as the frequency of complications related to VPS placement.
RESULTS RESULTS
Hydrocephalus was present at the time of NC diagnosis in 79.6% of patients. VPS dysfunction occurred in 48 patients (44.4%), mainly within the first year after placement (66.7%). The dysfunctions were not associated with the location of the cyst, the inflammatory characteristics of the cerebrospinal fluid or the administration of cysticidal treatment. They were significantly more frequent in patients in whom the decision to place a VPS was made in the emergency department. Two years after VPS, patients' Karnofsky score averaged 84.6±15 and only one patient died of a cause directly related to VPS.
CONCLUSIONS CONCLUSIONS
This study confirmed the utility of VPS and showed a significant improvement in the prognosis of patients requiring VPS compared with previous studies.

Identifiants

pubmed: 37204780
pii: 7173172
doi: 10.1093/trstmh/trad029
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

773-779

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Auteurs

Lya Cruz (L)

Research Unit on Neuroinflammation, Departamento de Medicina Genomica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

Edgar Pacheco (E)

Research Unit on Neuroinflammation, Departamento de Medicina Genomica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

Walter Soto (W)

Research Unit on Neuroinflammation, Departamento de Medicina Genomica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

Roberto Cong (R)

Research Unit on Neuroinflammation, Departamento de Medicina Genomica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

Roberto Suastegui (R)

Epilepsy Clinic, Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

Sergio Moreno-Jimenez (S)

Neurosurgery Department, Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

Agnès Fleury (A)

Research Unit on Neuroinflammation, Departamento de Medicina Genomica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México/Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.
Neurocysticercosis clinic, Instituto Nacional de Neurología y Neurocirugía, Insurgentes sur 3877, Tlalpan, 14269, México City, México.

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