Background Though parenchymal neurocysticercosis is common and a major contributor to burden of seizures in most parts of the world, intraventricular neurocysticercosis (IVNCC) comprises 10–20% of cases and poses a diagnostic challenge to the clinician. Case presentation We report an adult female presenting with intermittent occipital headache, used to be worse in lying down position, and aggravated with head movements, and there was mild relief in the sitting position. Her physical examination was unremarkable, and laboratory tests were within normal limits. Her multimodal neuroimaging showed cystic lesion in the fourth ventricle suggestive of neurocysticercosis. Patient underwent neuroendoscopic removal of the cyst, and the final diagnosis was confirmed on histopathology. Post removal of cyst patient had complete resolution of her symptoms. Discussion Intraventricular neurocysticercosis can present as acute hydrocephalus which may clinically manifest as Bruns’ syndrome in which sudden attacks of headache vertigo and nausea or vomiting are precipitated by abrupt head movements which was observed in our patient. Multimodal neuroimaging supported by histopathology helped in confirmation of the diagnosis, thus averting an inadvertent use of unnecessary medications in such patients. Furthermore, neuroendoscopy has evolved as minimally invasive technique for extirpation of fourth ventricular cysts.

中文翻译：

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表现为 Bruns 综合征的脑室内神经囊尾蚴病：一种不常见的表现

背景尽管实质神经囊尾蚴病很常见并且是世界大部分地区癫痫发作负担的主要因素，但脑室内神经囊尾蚴病 (IVNCC) 占病例的 10-20%，对临床医生的诊断提出了挑战。病例介绍 我们报告了一名成年女性，表现为间歇性枕部头痛，卧位时更严重，头部运动时加重，坐位时轻度缓解。体格检查无异常，实验室检查均在正常范围内。她的多模式神经影像学显示第四脑室有囊性病变，提示神经囊尾蚴病。患者接受了神经内窥镜切除囊肿，并通过组织病理学证实了最终诊断。切除囊肿后，患者的症状完全消失。讨论 脑室内神经囊尾蚴病可表现为急性脑积水，临床上可能表现为 Bruns 综合征，即在我们的患者中观察到的突然头部运动导致头痛眩晕和恶心或呕吐的突然发作。由组织病理学支持的多模式神经影像学有助于确诊，从而避免在此类患者中无意中使用不必要的药物。此外，神经内窥镜已经发展成为切除第四脑室囊肿的微创技术。由组织病理学支持的多模式神经影像学有助于确诊，从而避免在此类患者中无意中使用不必要的药物。此外，神经内窥镜已经发展成为切除第四脑室囊肿的微创技术。由组织病理学支持的多模式神经影像学有助于确诊，从而避免在此类患者中无意中使用不必要的药物。此外，神经内窥镜已经发展成为切除第四脑室囊肿的微创技术。