case_images: PMC6194729_01
case_images: (a-c) Axial and Sagittal magnetic resonance imaging views showing a cyst lesion on the left side of the fourth ventricle (a-b). Coronal view showing hydrocephalus with enlarged lateral and third ventricles (c)
case_images: SNI-9-201-g001.jpg
case_images: PMC6194729_01_SNI-9-201-g001.jpg
case_images: F1
case_images: The lesion was hypointense on T1-weighted and T2-weighted MRI sequences and had a peripheral millimetric solid component hyperintense on both sequences [Figure 1].
case_images: Another preoperative magnetic resonance imaging was done showing that the location of the cyst changed to the right side of the fourth ventricle
case_images: SNI-9-201-g002.jpg
case_images: PMC6194729_01_SNI-9-201-g002.jpg
case_images: F2
case_images: In this second exam, the lesion showed no contrast enhancement but had changed its location to the contralateral side within the fourth ventricle [Figure 2], revealing its mobile nature.
case_images: The postoperative MRI showing a complete cyst removal
case_images: SNI-9-201-g003.jpg
case_images: PMC6194729_01_SNI-9-201-g003.jpg
case_images: F3
case_images: Postop MRI showed a total removal of the cyst lesion and reduction of the ventricle dimensions [Figure 3].
case_images: Histopathological examination with haematoxylin and eosin stain showing three distinct layers consistent with a Taenia solium cyst: a cuticular layer with hair-like microtrichia, a middle cellular layer, and an inner reticular layer with focal calcification
case_images: SNI-9-201-g004.jpg
case_images: PMC6194729_01_SNI-9-201-g004.jpg
case_images: F4
case_images: The pathology report confirmed the cyst to be a T. solium larva in its vesicular stage as had already been suspected [Figure 4].
case_images: (a-b). Five-week postoperative magnetic resonance imaging showing a pseudomeningocele due to recurrent hydrocephalus (a) with no flow in the previous ventriculostomy (b)
case_images: SNI-9-201-g005.jpg
case_images: PMC6194729_01_SNI-9-201-g005.jpg
case_images: F5
case_images: The MRI showed hydrocephalus recurrence with no evidence of CSF flow through the previous ventriculostomy stoma [Figure 5].
case_images: (a-c). Intraoperative imagens showing multiple debris fragments floating in the ventricular space (a, b) and the reopening of the ventriculostomy (c)
case_images: SNI-9-201-g006.jpg
case_images: PMC6194729_01_SNI-9-201-g006.jpg
case_images: F6
case_images: Intraoperatively, we visualized a transparent CSF plenty of floating debris [Figure 6].
case_images: (a-b). Postoperative magnetic resonance imaging at 5-month follow-up showing no hydrocephalus or any recurrent or residual cyst
case_images: SNI-9-201-g007.jpg
case_images: PMC6194729_01_SNI-9-201-g007.jpg
case_images: F7
case_images: The 5-month postop MRI ruled out hydrocephalus or any recurrent lesion [Figure 7].