Hemifacial Spasm Secondary to Arachnoiditis Due to Neurocysticercosis: Clinical Image.

Subarachnoid neurocysticercosis (NCC) is a form of NCC with cysticerci located in the subarachnoid space. This form of NCC can cause general and focal neurologic symptoms, and sometimes requires surgical intervention as a treatment. In this report, we present a rare case of hemifacial spasm secondary to arachnoiditis because of an NCC cyst in the cerebellopontine angle. The cysticercus was removed and the facial nerve was liberated via a retrosigmoidal approach. At 8-month follow-up, the patient reported no recurrence of symptoms. To our knowledge, this is the first case reported to surgically manage hemifacial spasm secondary to NCC arachnoiditis.

Hydatid cysts of the internal acoustic canal and jugular foramen.

Brain involvement with hydatid disease occurs in 1-2% of all Echinococcus granulosus infections. Cerebral hydatid cysts are usually supratentorial, whereas infratentorial lesions are quite rare. Here we report a 19-year-old man with hydatid cysts in the right cerebellopontine cistern with the involvement of internal acoustic canal and jugular foramen. The patient presented with signs of increased intracranial pressure and multiple cranial nerve palsies. Surgery was performed in the semi-sitting position using a lateral suboccipital approach for a right-sided craniotomy. Magnetic resonance imaging clearly demonstrated cisternal, neural and vascular relationships which aided in intact surgical removal of the lesion using microsurgical techniques. Total removal without rupture should be the surgical goal in all hydatid cysts.

[Unusual cause for bilateral trigeminal neuralgia: unilateral racemous cysticercus of cerebellopontine angle. Case report]. / Neuralgia do trigêmeo bilateral por cisticerco racemoso unilateral no ângulo-ponto cerebelar: relato de caso.

We report the case of a 42-year-old woman with a racemous cystecercus in the right cerebellopontine angle (CPA), who presented with bilateral trigeminal neuralgia. The parasite was completly removed via a right suboccipital craniotomy. On the first postoperative day, the patient indicated that the pain disappeared. The neuralgia was caused by two probable mechanisms: a distortion of the brain stem and compression of the nerve against an arterial loop at the entry zone or arachnoiditis caused by the parasite in the both CPA cisternae. This case demonstrates the advisability of obtaining imaging studies in all patients with trigeminal neuralgia before starting any management. We must always remind that the cysticercus may be a differential diagnosis of CPA lesions.

Neuralgia do trigêmeo bilateral por cisticerco racemoso unilateral no Angulo-ponto cerebelar: relato de caso / Bilateral trigeminal neuralgia caused by unilateral racemose cysticercus of cerebellopontine angle. Case report

Descrevemos o caso de uma paciente de 42 anos portadora de cisticerco racemoso na regiäo do ângulo ponto-cerebelar (APC) direito com trigeminalgia bilateral mais intensa no lado ipsilateral à localizaçäo do parasita. O cisticerco foi totalmente removido por meio de craniotomia suboccipital. No primeiro dia pós-operatório houve desaparecimento bilateral da dor. Duas hipóteses fisiopatológicas foram aventadas para explicar a sintomatologia: lesöes que ultrapassam os limites da cisterna do APC poderäo através da cisterna pré-pontina alcançar a cisterna do APC atingindo o trigêmeo contralateral; lesöes com grande efeito de massa poderäo provocar rotaçäo do tronco cerebral e deslocamento e traçäo de estruturas ipsi e contralaterais, provocando compressäo arteriovenosa sobre o trigêmeo contralateral na porççÒo superior da cisterna do APC. Salientamos a necessidade de exames de imagem ante qualquer algia craniofacial e observamos que, em lesöes na regiäo do APC, a cisticercose näo pode ser esquecida