Neuroendoscopia Brasil

Hydrocephalus in Neurocysticercosis and Other Parasitic
and Infectious Diseases


The cestode species are the most common parasites that affect the central nervous system (CNS). Five different cestode infections of the nervous system are: cysticercosis, from the larva of Taenia solium –
the most common of them, with more than 50 000 people infected worldwide; hydatidosis (hydatic cyst disease), from the larva of Echinococcus granulosus; alveolar cyst disease from the larva of Echinococcus multilocularis; coenurosis, a rarer type, from the larva of Taenia multiceps; and, exceptionally, sparganosis from the larva of Spirometra mansonoides.Only the most important ones and those related to hydrocephalus will be discussed
here – cysticercosis and hydatidosis. Three other infections are common and may lead to hydrocephalus.
They are fungal, viral, and infections by Mycobacterium tuberculosis. Other bacterial ventriculitis will not be discussed in this chapter.

Epidemiology Cysticercosis infects about 50 million people around the world, 50 000 of whom die each year. It
is found, alongside pork tapeworm infestation, in countries with poor hygiene habits. It is rare in most of Europe; in Asia reports are sparse. It occurs frequently in India, the northern coast of Africa, especially Egypt, and among the natives of southern Africa. Cysticercosis is rare in the United States of America, but is the leading cause of hydrocephalus and seizures among Hispanic Americans living in Los Angeles and California [4, 59]. Latin America is the area with the highest incidence of cysticercosis – it is referred from Mexico to Argentina and Chile.

From all autopsies in Mexico in 1979, 1.9% showed infection by T. solium. Colli et al. reported that 2.7% of hospital admissions for neurological diseases in the city of São Paulo in 1986 were due to neurocysticercosis [17]. Admissions in the pediatric age group due to neurocysticercosis comprised 2%-10% of all cases. The habit of repeatedly introducing their fingers into their mouths and easy contact with the soil expose children to a higher risk of massive cestode infections. Statistically, older people are less affected [12, 39]. Cysticercosis affects mostly people with lower living standards. Though a few studies have shown a higher incidence among males, there seems to be no sex preponderance, and as to age, the peak incidence is between 25 and 35 years [52].

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