Advances in the management of pineal region neurocysticercosis: A surgical and anatomical study.
- 1Department of Neurosurgery , General Hospital Tláhuac, ISSSTE, Tláhuac, Mexico City, Mexico.
- 2Department of Pathology, General Hospital Tláhuac, ISSSTE, Tláhuac, Mexico City, Mexico.
Abstract
Background
Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system; however, involvement of the pineal region is exceptionally rare. The scarcity of reported cases and the anatomical complexity of this region make surgical management challenging. We aim to provide an anatomical review, a systematic review of the literature, and an illustrative surgical case to provide a reference for the surgical management of future cases.Methods
An observational, descriptive, and analytical study was conducted, including an anatomical review of the pineal region, a Preferred Reporting Items for Systematic Reviews and Meta-Analyses -guided systematic review of the literature, and the surgical management of a patient with pineal region NCC.Results
The systematic review demonstrated that NCC most frequently involved the cerebral parenchyma (33.91%) and the intraventricular compartment (30.41%), in contrast with the pineal region that accounted for only 0.69% of reported cases. Our illustrative case was managed with endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus, followed by microsurgical resection through a supracerebellar infratentorial approach in the semisitting position. Endoscopic inspection confirmed complete cyst removal. Histopathological examination established the diagnosis of NCC, and the patient had an uneventful post-operative course with complete resolution of hydrocephalus and no procedure-related complications.Conclusion
Pineal region NCC requires individualized surgical management. In selected patients with obstructive hydrocephalus, a staged strategy consisting of ETV followed by microsurgical resection with endoscopic confirmation of complete excision appears to be a safe and effective treatment. This case adds to the limited evidence available and may help guide the management of this rare condition.
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BibTeX
@article{villegas2026advances,
title = {{Advances in the management of pineal region neurocysticercosis: A surgical and anatomical study.}},
author = {Jose Carlos Rocha Villegas and Eva Samantha Moreno Zerecero and Alfredo Valero Gomez and Alejandro Monroy-Sosa},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_920_2026},
url = {https://europepmc.org/article/MED/42974255},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Advances in the management of pineal region neurocysticercosis: A surgical and anatomical study.
AU - Jose Carlos Rocha Villegas
AU - Eva Samantha Moreno Zerecero
AU - Alfredo Valero Gomez
AU - Alejandro Monroy-Sosa
PY - 2026
DA - 2026/10/16
JO - Surgical neurology international
DO - 10.25259/sni_920_2026
UR - https://europepmc.org/article/MED/42974255
AB - Background Neurocysticercosis (NCC) is the most common parasitic infection of the central nervous system; however, involvement of the pineal region is exceptionally rare. The scarcity of reported cases and the anatomical complexity of this region make surgical management challenging. We aim to provide an anatomical review, a systematic review of the literature, and an illustrative surgical case to provide a reference for the surgical management of future cases.Methods An observational, descriptive, and analytical study was conducted, including an anatomical review of the pineal region, a Preferred Reporting Items for Systematic Reviews and Meta-Analyses -guided systematic review of the literature, and the surgical management of a patient with pineal region NCC.Results The systematic review demonstrated that NCC most frequently involved the cerebral parenchyma (33.91%) and the intraventricular compartment (30.41%), in contrast with the pineal region that accounted for only 0.69% of reported cases. Our illustrative case was managed with endoscopic third ventriculostomy (ETV) for obstructive hydrocephalus, followed by microsurgical resection through a supracerebellar infratentorial approach in the semisitting position. Endoscopic inspection confirmed complete cyst removal. Histopathological examination established the diagnosis of NCC, and the patient had an uneventful post-operative course with complete resolution of hydrocephalus and no procedure-related complications.Conclusion Pineal region NCC requires individualized surgical management. In selected patients with obstructive hydrocephalus, a staged strategy consisting of ETV followed by microsurgical resection with endoscopic confirmation of complete excision appears to be a safe and effective treatment. This case adds to the limited evidence available and may help guide the management of this rare condition.
SN - 2229-5097
SN - 2152-7806
ER -