Neurocysticercosis is primarily managed with anthelminthic, antiepileptic, and corticosteroid therapies. Surgical removal of the larval cyst is indicated when associated mass effect causes neurological symptoms, as demonstrated in two cases. Cyst resection was achieved via the far lateral approach for a cervicomedullary cyst in one patient and via the subtemporal approach for a mesencephalic cyst in another. The cyst wall should be kept intact, when possible, to avoid dissemination of the inflammation-evoking contents. As the contents are usually semisolid and can be removed via suction, it is not necessary to remove the gliotic capsule or adherent portions of the cyst wall in highly eloquent locations. The video can be found here: https://youtu.be/GqbaJu5sy1o.
Keywords: brainstem; cyst; far lateral approach; inflammation; larva; neurocysticercosis; subtemporal approach; tapeworm; video.
© 2019, Xiaochun Zhao, Robert T. Wicks, Evgenii Belykh, Colin J. Przybylowski, Mohamed A. Labib, and Peter Nakaji.