Disseminated Neurocysticercosis with Chronic Ischaemic Brain Changes: A Rare Case Presentation

Neurocysticercosis (NCC), a parasitic infection caused by Taenia solium , remains a significant health concern in endemic regions. Disseminated NCC, involving multiple body regions, is rare and often presents diagnostic challenges. This report highlights a case of disseminated NCC with concurrent early chronic ischaemic changes in a 41-year-old female. The patient presented with chronic headaches, intermittent dizziness and mild motor weakness for over 6 months. Magnetic resonance imaging of the brain revealed mild diffuse cerebral atrophy and multiple punctate T2-weighted fluid-attenuated inversion recovery (T2/FLAIR) hyperintensities in the bilateral fronto-parietal white matter indicative of early chronic ischaemic changes. Screening of the spine showed multiple elongated T2 hyperintense cystic lesions in the cervical and dorsal paraspinal regions and focal posterocentral disc protrusion at the C5–C6 level. Histopathological evaluation of an excised myocutaneous cyst revealed fibrocollagenous tissue with cyst walls composed of eosinophilic material and calcified spherules, confirming the diagnosis of chronic disseminated NCC. Laboratory findings revealed elevated eosinophil levels (13%), further supporting a parasitic aetiology. The patient was managed with albendazole and corticosteroids, along with symptomatic therapy for headache and motor weakness. She was advised to have regular follow-ups to monitor disease progression and evaluate therapeutic outcomes. This case emphasises the importance of a multidisciplinary approach, including radiological, histopathological and laboratory investigations, in diagnosing and managing disseminated NCC. The coexistence of chronic ischaemic changes underscores the need for a comprehensive evaluation to identify secondary complications of parasitic infections. Early diagnosis and targeted treatment can improve clinical outcomes and prevent long-term sequelae.