Board Review 3 – Case 11

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case shows a nodular lesion with calcification in the right frontal lobe. There is surrounding vasogenic edema with sparing of the cortex. CT images from higher in the brain show other areas of calcification at the gray-white junction thoughout the brain.

MR confirms these findings. There is an area of right frontal edema with a rounded enhancing structure at the gray-white junction. There is a differential diagnosis for this finding which includes infection and metastatic disease.

The diagnosis is: neurocysticercosis

Neurocysticercosis is a parasitic infection with a dual life cycle that goes through pigs and humans. When eggs excreted in human feces are ingested, it can affect the CNS. It is the most common cause of acquired seizure in endemic areas.

The treatment is anti-parasitic agents, specifically albendazole.