MR imaging in cysticercotic encephalitis

Cysticercotic encephalitis is a severe form of neurocysticercosis in which the brain parenchyma is harmed by the host immune response to massive cysticerci infestation. Patients with this disorder usually present abnormalities of consciousness associated with intracranial hypertension, visual changes and generalized seizures. Because these are non-specific clinical manifestations, the diagnosis largely depends on demonstration of characteristic lesions by CT. CT findings include diffuse brain edema, small lateral ventricles without midline shift, and multiple round and small areas of abnormal enhancement after administration of contrast material. MR has been of great value in the diagnosis of neurocysticercosis; it is superior to CT in recognition of edema around cysticerci and internal changes indicative of cyst death. In cysticercotic encephalitis, most lesions represent dying parasites surrounded by severe edema; therefore, MR should be an ideal study for these cases. In this report, we evaluate the usefulness and features of MR in two patients with cysticercotic encephalitis.