Form* | Characteristic on neuroimaging | Histopathology |
Parenchymal¶ | ||
Nonviable calcified | Nodular calcifications <20 mm in diameter (often 1 to 5 mm) with or without surrounding edema and/or contrast enhancement. | Calcified granuloma with or without surrounding inflammation and/or gliosis. |
Single, small enhancing | Cystic or nodular enhancing lesion <2 cm in size. | Single parenchymal parasites in the process of degeneration with surrounding inflammation and variable opacification or absence of the cyst fluid. |
Viable parenchymal | Vesicular lesions often with evidence of associated contrast enhancement and/or surrounding edema. The scolex is often visible on high-definition imaging. | Parasites with intact cyst wall, vesicular fluid, and scolex, with variable amounts of inflammation surrounding the parasite sometimes invading the cyst wall. |
ExtraparenchymalΔ | ||
Intraventricular | Cysticerci within the ventricles, obstructive hydrocephalus or loculated hydrocephalus with disproportionate dilatation of the ventricles in CT/MRI (suggestive of a cysticercus). | Viable cysticercus cyst within the ventricle and/or obstructive hydrocephalus. |
Subarachnoid | Cysticerci in the Sylvian fissure, in the basilar cisterns, or interhemispheric spaces. Strokes or meningitis without discrete cysts. | Cysticerci in the subarachnoid space often with arachnoiditis, vasculitis. The cysticerci are often in clusters with proliferating membranes (racemose) and may lack a scolex. |
Spinal | Cysticerci within the spinal subarachnoid space with or without evidence of inflammation/diffuse spinal arachnoiditis. Intramedullary cysticerci within the spinal cord. | Subarachnoid cysticerci often with associated arachnoiditis. Intramedullary cysticerci similar pathologically to parenchymal cysticerci. |
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