Images in Clinical Tropical Medicine Positional Headaches in a Young Brazilian Woman

A 26-year-old Brazil-born woman was hospitalized because of severe headaches that increased in severity when she moved her head. T2-fluid attenuated inversion recovery mag-netic resonance imaging showed a cystic-like lesion in the right occipital horn of the lateral ventricle (Figure 1). Repeat magnetic resonance imaging of a ventral decubitus position showed that the free-floating cyst shifted anteriolaterally to the base of the lateral ventricle (Figure 2) and partially occluded the interventricular foramen (Figure 3). Enzyme-linked immunosorbent assay identified IgG against Taenia solium cysticercosis in cerebrospinal fluid and serum samples. She underwent uneventful neuroendoscopic removal of a 1.3-cm cyst (Figure 4) that was histologically compatible with a T. solium larval stage infection. Positional headaches, a char-acteristic feature of spontaneous intracranial hypotension, clus-ter headaches, and various brain tumors such as colloid cysts, are commonly self-reported by patients with intraventricular neurocysticercosis. Infections with this parasite result in partia