Parasite: Taenia solium
The condition is associated with the aberrant spread of slowly-proliferating larva. There are disorganized cyst elements which often lack a scolex and which may or may not show racemose cysts ("bunch of grape"-like collection of multiple fluid-filled vesicles).
Pathogenesis:
(1) mass effect if there are numerous cysts
(2) acute and chronic arachnoiditis
Imaging studies can show the spread of the infection in the subarachnoid space with extension:
(1) along the course of the cerebral and basilar arteries.
(2) around the spinal cord
Presenting features may include:
(1) headaches
(2) seizures
Complications:
(1) hydrocephalus
(2) cranial nerve entrapment
(3) brain infarcts
(4) optic nerve entrapment with impaired vision
(5) impaired balance and walking
(6) work disability
(7) aneurysm
With effective therapy there is normalization of cerebral spinal fluid parameters and undetectable CSF cestode antigen.
