ArticleEClinicalMedicine2026
Effect of different management strategies on outcomes in subarachnoid neurocysticercosis: a descriptive, multicentre, retrospective cohort study in the USA.
Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Subarachnoid neurocysticercosis (SANCC) is an uncommon but severe form of Methods: We performed a multicentre retrospective cohort study with patients from 15 medical centres across nine states in the USA. SANCC was defined based on histopathology; the presence of cysts in the basilar subarachnoid spaces/sylvian fissures/spine with antibody positivity to Findings: Data were collected on 75 patients with neurocysticercosis. Of whom, six patients were determined to not meet the definition of SANCC and were excluded; ultimately, 69 (40 male, 29 female) met the definition of SANCC. The year of case-defining SANCC hospitalisation ranged from 2009 to 2022, with a median year of 2016. Median 2.5 years, interquartile range (IQR) 0.94-4.0 years. SANCC was a new diagnosis in 59 patients. Of these, 18 (31%) had prior medical visits for SANCC manifestations (i.e. hydrocephalus [17%], stroke [5%], and/or meningitis [7%], brain mass [3.3%], TIA [1.6%], or intracranial hypertension without hydrocephalus [1.6%]) but SANCC was not considered. At the time of discharge, 9 (13%) patients were not given albendazole and/or praziquantel due to cost or availability. 52 patients had >60 of post-hospitalisation follow-up and completed the intended course of therapy. Use of CSF Interpretation: SANCC is commonly misdiagnosed and diagnostic and therapeutic delays may lead to more subsequent hospital encounters for SANCC-related problems. Use of CSF Ts biomarkers to guide anthelmintic therapy may decrease SANCC recurrence. However, given the small sample size, adjustment for confounders with regression analysis was not performed and we cannot exclude confounding as responsible for differences seen. Larger, prospective studies are needed to confirm these findings. Funding: Division of Intramural Research, National Institute of Allergy and Infectious Diseases.
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