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Inflammatory biomarkers predict incident and recurrent cardiac events, but their relationship to stroke prognosis is uncertain. We hypothesized that high-sensitivity C-reactive protein (hsCRP) predicts recurrent ischemic stroke after recent lacunar stroke.

This review comments on the recent advances in the understanding of the controversial aspects of neurocysticercosis (NCC).

Background and Purpose—Stroke is a leading cause of mortality and disability in South America because of an increase in life expectancy and changes in the lifestyle of the population. Because epidemiological and clinical characteristics of stroke vary according to regional factors, we need to know the peculiarities of stroke on this continent.

To determine the prevalence and subtypes of cerebrovascular complications of Bothropsspp. snakebites.

Prevalence of cerebral microbleeds (CMB) in white and Asian populations range from 4 to 15. However, there is no information from indigenous Latin American people. We aimed to assess prevalence and cerebrovascular correlates of CMB in stroke-free older adults living in rural Ecuador.

We report two patients who presented with intracranial hypertension without localizing signs and normal computed tomography (CT) scans. In both cases, the diagnosis of pseudotumor cerebri was erroneously made until the results of cerebrospinal fluid (CSF) analysis demonstrated cysticercosis. Our findings reinforce the concept that the diagnosis of pseudotumor cerebri should not be made without study of CSF, and add another cause for the syndrome of pseudopseudotumor.

We tapered antiepileptic drugs in 40 patients with epilepsy due to neurocysticercosis who had been free of seizures for 2 years. All patients previously received a course of albendazole that resulted in complete destruction of brain cysts. We followed the patients prospectively from the time of diagnosis until 12 months after antiepileptic drug withdrawal. We evaluated the following prognostic factors for seizure recurrence: sex, number of seizures before control, type of seizures, number of parenchymal brain cysts before albendazole therapy, EEG findings, and CT findings after albendazole therapy. In the univariate analysis of prognostic factors for seizure recurrence, the development of brain calcifications caused by albendazole was the only factor associated with a significantly higher rate of relapse (p= 0.004). The multivariate analysis showed that patients who had both recurrent seizures and multiple brain cysts also had a higher risk of relapse than those with single seizures or single cysts (p= 0.05). This study suggests that the prognosis of epilepsy due to neurocysticercosis is not as benign as previously thought. Patients with residual calcifications and those with both recurrent seizures and multiple cysts before albendazole therapy have the highest rate of relapse after withdrawal of antiepileptic drugs.

Neurocysticercosis is a pleomorphic parasitic disease that may mimic almost any other condition affecting the central nervous system. Recent studies have focused on diagnostic strategies and treatment of the most severe forms of the disease. This review covers the novel contributions made in those areas.

• Albendazole is considered to be the drug of choice for treatment of parenchymal brain cysticercosis. Its efficacy, however, for treatment of subarachnoid cysticerci has not been established, to our knowledge. In this study, we treated four patients who had giant subarachnoid cysticerci with albendazole at daily doses of 15 mg/kg of body weight for 8 days. Computed tomographic studies showed that all cysts disappeared 3 months after the end of treatment. This was associated with marked clinical improvement in every case. Our results indicated that albendazole is highly effective for treatment of this form of the disease.

• Albendazole is now used for therapy of neurocysticercosis; however, duration of treatment has usually been empirically determined. In this study we shortened the length of therapy from one month in previous reports, to one week. Twelve patients with parenchymal brain cysticercosis were treated with albendazole for eight days at daily doses of 15 mg/kg of body weight. After three months of treatment the number of cysts on computed tomography had decreased from 185 to six; a 97% reduction in the number of lesions. Total remission of all cysts was seen in nine patients. Two cases had been unsuccessfully treated before with praziquantel, in both instances albendazole therapy was effective with 100% improvement. Our results indicated that a short course of albendazole is highly effective for treatment of neurocysticercosis.

The efficacy of albendazole (15 mg/kg/d for 1 week) was compared with praziquantel (100 mg/kg in three divided doses at 2-hour intervals) for therapy of parenchymal brain cysticercosis. Ten patients were treated with albendazole and 10 patients with praziquantel. Although the total number of cysts was significantly reduced from 64 to 7 in patients treated with albendazole and from 59 to 24 in those treated with praziquantel, the number of patients improving with albendazole was not significantly different from those treated with praziquantel.

We describe 11 patients with massive brain infection with viable cysticerci, undetectable inflammatory reaction on CNS imaging, and an unexpectedly high (82%) prevalence of tapeworm infection. With the exception of two individuals with heavy parasite loads, patients had a relatively benign clinical course and tolerated the use of cysticidal drugs. This group of patients represents a particular presentation of neurocysticercosis, different from the previously described syndromes of cysticercotic encephalitis and disseminated systemic cysticercosis.

A previously healthy 35-year-old man developed sudden diplopia after smoking “crack” cocaine. Neuro-ophthalmologic examination revealed findings consistent with a tegmental mesencephalic lesion which correlated closely with the computed tomographic documentation of a small midbrain hemorrhage. Cocaine abuse is a recognized cause of intracranial hemorrhage. In most patients, however, the bleeding is localized in the subarachnoid space or the subcortical white matter. To our knowledge, this is the first case of isolated midbrain hemorrhage secondary to cocaine abuse.