A 19-year-old man, right-handed, with a history of eating frequently undercooked snake meat.
She presented with a mild, oppressive, occipital headache of two weeks duration, associated with a gradual and progressive decrease in muscle strength of the left hemibody and paresthesias that began in the upper limb, and then in the lower limb.
Physical examination revealed proportional and direct left hemiparesis and left hemihypoesthesia for all modalities.
A pyramidal syndrome and a thalamic syndrome were diagnosed.
A computerized axial tomography (CAT) of the encephalon was performed. Four lesions of the right ventricle were associated with thalamus lesions and 18 mm were associated with ring enhancement, hypodense and concentric center.
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Glucocorticoids were indicated and a stereotactic guided biopsy was performed with the patient awake.
After scalp anesthesia with 0.5% lidocaine, the Cuban framework Esteroflex® was placed.
Planning TAC was performed, the Cartesian coordinates were calculated and the entry point and trajectories were planned using the Stassis program version 3.0.
A calcifying area belonging to the coordinates X=85, Y=89, Z=36, was identified as "T2" point a lateral end zone with enhancement corresponding to the coordinates X=80 and Z=80.
Under local anesthesia, an incision was made, along with a sharpening about Koscher's point.
Dural coagulation and cruciform opening, coagulation and pial opening were performed.
Four samples were taken in different previously determined whites (6, 12, 18 and 24 hours).
In one of the samples corresponding to an enhanced nodule, a possible whitish-colored and non-white appearance was observed.
The patient presented a transient increase in paresthesia during the surgical procedure without any other complication.
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An immediate post-surgical CT scan showed low air at the biopsy site with no signs of bleeding or other complications and a CT scan at two months in which total remission of the lesions was observed.
Histopathological examination revealed a solid, irregular segment surrounded by hyalinization and fibrosis, with calcified and homogeneously eosinophilic variables.
No scolex was found.
Initially, treatment with albendazole was indicated in a 15 mg daily regimen, in three daily doses.
The initial ELISA test in blood and cerebrospinal fluid (CSF) was positive for Sparganum-specific immunoglobulin (IgG).
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The evolution of the patient was satisfactory, after eight weeks all symptoms disappeared and he was incorporated to his usual life.
ELISA test in blood and control CSF at 12 weeks was negative.
