Abstract
A 15 years old girl of African origin was admitted with a history of headaches and a generalised tonic seizure. Her clinical examination including fundoscopy was normal. She claimed she had been assaulted. Within a few hours of her admission she was found dead in her bed during the ward round. Cardiopulmonary resuscitation was unsuccessful. At post-mortem, the major organs showed no pathological changes and neck dissection showed no abnormality. Neuropathological examination after formalin fixation revealed a cystic lesion in the fourth ventricle, ependymitis and acute hydrocephalus. Histology showed parts of the parasite Taenia solium and the diagnosis was neurocysticercosis. This case highlights the need for forensic and general pathologists as well as forensic medical examiners and paediatricians to be aware of neurocysticercosis as a possible cause of sudden death in the presence of normal clinical findings and negative autopsy, especially in patients from Asian, African or South American countries. As cysticercosis is the commonest cause of seizures in the developing world, neurocysticercosis needs to be considered as a cause of sudden and unexpected death in any patient with a history of headaches and/or seizures.
Similar content being viewed by others
References
Esberg G, Reske-Nielsen E (1988) Sudden death from cerebral cysticercosis. Scand J Infect Dis 20:679–684
Bent Hamida M, Moulonguet A, Romano P, Gray F (1993) Confrontation at the Salpetriere hospital. May 1991 Cephalagia developing in depressive background and sudden death in a 26 year old woman. Rev Neurol (Paris) 149:362–366
Ndhlovu CE (1997) An uncommon presentation of cysticercosis. Cent Afr J Med 43:207–209
DeGiorgio CM, Houston I, Oviedo S, Sorvillo F (2002) Deaths associated with cysticercosis. Report of three cases and review of the literature. Neurosurg Focus 12:e2
Verma SK, Agarwal BB, Agarwal G (1998) Sudden death in neurocysticercosis by trauma. Forensic Sci. Int. 95:23–26
Rao KR, Lessing D (2003) Neurocysticercosis in West London. Arch Dis Child 88:471
DeGiorgio CM, Medina MT, Duron R, Zee C, Escueta SP (2004) Neurocysticercosis. Epilepsy Curr 4:107–111
Del Brutto OH (2005) Neurocysticercosis. Semin Neurol 25:243–251
Rosenfeld E (2003) Neurocysticercosis. Update Pediatr Infect Dis J 22:181–182
Oeberst JL, Barnard JJ, Bigio EH, Prahlow JA (2002) Neurocysticercosis. Am J Forensic Med. Pathol (2002) 23:31–35
Rajshekhar V, Joshi DD, Doanh NQ, van De N, Xiaonong Z (2003) Taenia solium taeniosis/cysticercosis in Asia: epidemiology, impact and issues. Acta Trop 87:53–60
White AC Jr (1997) Neurocysticercosis: a major cause of neurological disease worldwide. Clin. Infect. Dis. 24:101–115
Gubbay AD, Brophy BP, Henley S, Sage M (1998) Neurocysticerosis. J Clin Neurosci 5:203–207
Pitella JEM (1997) Neurocysticercosis. Brain Pathol 7:681–693
Deb KP, Carpio A, Sander JWAS (2000) Neurocysticercosis and epilepsy in developing countries. J. Neurol. Neurosurg. Psychiatry 68:137–143
Goodyear M, Voyvodic F, Brophy B, Sage M (1997) Spinal cysticercosis. J. Clin. Neurosci 4:25–27
De Souza Queiroz L, Filho AP, Callegaro D, De Faria LL (1975) Intramedullary cysticercosis. Case report, literature review and comments on pathogenesis. J Neurol Sci 26:61–70
Adhisivam B (2004) Starry sky: multiple neurocysticercosis. Arch Dis Child Educ Pract 89:ep75
Biedrzycki O, Hortobágyi T, Alhakim A, Hunt N, Djurovic V, Al-Sarraj S (2006) Sudden deaths caused by intraventricular cysts, neuropathol. Appl. Neurobiol 32:240 [Abstract]
Jarquin-Valdivia AA, Rich AT, Yarbrough JL, Thompson RC (2005) Intraventricular colloid cyst, hydrocephalus and neurogenic stunned myocardium. Clin. Neurol. Neurosurg. 107:361–365
Garcia HH, Evans CA, Nash TE, Takayanagui OM, White AC Jr, Botero D, Rajshekhar V, Tsang VC, Schantz PM, Allan JC, Flisser A, Correa D, Sarti E, Friedland JS, Martinez SM, Gonzalez AE, Gilman RH, Del Brutto OH (2002) Current consensus guidelines for treatment of neurocysticercosis. Clin Microbiol Rev 15:747–756
Author information
Authors and Affiliations
Corresponding author
Additional information
Tibor Hortobágyi and Ali Alhakim are first authors who contributed equally to this work.
Rights and permissions
About this article
Cite this article
Hortobágyi, T., Alhakim, A., Biedrzycki, O. et al. Cysticercosis of the Fourth Ventricle Causing Sudden Death: A Case Report and Review of the Literature. Pathol. Oncol. Res. 15, 143–146 (2009). https://doi.org/10.1007/s12253-008-9098-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12253-008-9098-9