# Racemose Neurocysticercosis Presenting As Vasculitic Infarct and Obstructive Hydrocephalus: A Rare Presentation

**Authors:** Rishabh Rawat, Gopinadh Tummagunta, Geeta Kampani, Hrishabh Singh, Fayaz Hussain Azad

PMC · DOI: 10.7759/cureus.78418 · Cureus · 2025-02-03

## TL;DR

This paper presents a rare case of racemose neurocysticercosis causing stroke and hydrocephalus, emphasizing the importance of early diagnosis and treatment for better outcomes.

## Contribution

The paper highlights a rare clinical presentation of racemose NCC and advocates for prompt treatment with antiparasitic agents and steroids.

## Key findings

- Racemose NCC can present as vasculitic infarct and obstructive hydrocephalus.
- Combination therapy with albendazole, praziquantel, and dexamethasone led to clinical improvement.
- Early diagnosis and treatment are crucial for minimizing neurological complications.

## Abstract

Racemose neurocysticercosis (NCC) is a rare and aggressive form of parasitic infection that primarily involves the subarachnoid space. It can lead to serious complications such as hydrocephalus and ischemic stroke due to vasculitis. Early recognition of this condition is essential for preventing long-term neurological damage. This report discusses a case of a 68-year-old male who presented with sudden onset right-sided hemiplegia and facial palsy despite having no previous comorbidities. Imaging studies revealed extraparenchymal cystic lesions consistent with racemose NCC, leading to obstructive hydrocephalus and stroke.

The patient was treated with a combination of albendazole, praziquantel, and dexamethasone. Following three weeks of therapy, he demonstrated marked clinical improvement and was subsequently discharged with instructions for follow-up care. This case highlights the critical need for timely diagnosis and management of racemose NCC to improve neurological outcomes. Prompt treatment using antiparasitic agents and steroids can play a pivotal role in facilitating recovery and minimizing complications. Recognizing racemose NCC as a potential cause of stroke and hydrocephalus in endemic areas is vital for early intervention and enhanced patient outcomes.

## Linked entities

- **Chemicals:** albendazole (PubChem CID 2082), praziquantel (PubChem CID 4891), dexamethasone (PubChem CID 5743)
- **Diseases:** hydrocephalus (MONDO:0001150), stroke (MONDO:0005098), hemiplegia (MONDO:0001170)

## Full-text entities

- **Diseases:** neurological damage (MESH:D020196), Vasculitic Infarct (MESH:D007238), parasitic infection (MESH:D010272), facial palsy (MESH:D005158), stroke (MESH:D020521), ischemic stroke (MESH:D002544), cystic lesions (MESH:D052177), vasculitis (MESH:D014657), hemiplegia (MESH:D006429), Obstructive Hydrocephalus (MESH:D006849), NCC (MESH:D020019)
- **Chemicals:** albendazole (MESH:D015766), dexamethasone (MESH:D003907), steroids (MESH:D013256), racemose NCC (-), praziquantel (MESH:D011223)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC11882129/full.md

## References

18 references — full list in the complete paper: https://tomesphere.com/paper/PMC11882129/full.md

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Source: https://tomesphere.com/paper/PMC11882129