Criteria
Revised diagnostic criteria for neurocysticercosis[51]
Absolute criteria:
Histological demonstration of the parasite from biopsy of a brain or spinal cord lesion
Visualisation of sub-retinal cysticercus
Conclusive demonstration of a scolex within a cystic lesion on neuroimaging studies.
Neuroimaging criteria:
Major neuroimaging criteria:
Cystic lesions without a discernible scolex
Enhancing lesions
Multilobulated cystic lesions in the subarachnoid space
Typical parenchymal brain calcifications
Confirmative neuroimaging criteria:
Resolution of cystic lesions after cysticidal drug therapy
Spontaneous resolution of single small enhancing lesions (use of corticosteroids makes this criterion invalid)
Migration of ventricular cysts documented on sequential neuroimaging studies
Minor neuroimaging criteria:
Obstructive hydrocephalus (symmetrical or asymmetrical) or abnormal enhancement of basal leptomeninges.
Clinical/exposure criteria:
Major clinical/exposure:
Detection of specific anticysticercal antibodies or cysticercal antigens by well-standardised immunodiagnostic tests
Cysticercosis outside the central nervous system
Evidence of a household contact with Taenia solium infection
Minor clinical/exposure:
Clinical manifestations suggestive of neurocysticercosis
Individuals coming from or living in an area where cysticercosis is endemic.
Definitive diagnosis:
One absolute criterion
Two major neuroimaging criteria plus any clinical/exposure criteria
One major and one confirmative neuroimaging criterion plus any clinical/exposure criteria
One major neuroimaging criterion plus two clinical/exposure criteria (including at least one major clinical/exposure criterion), together with the exclusion of other pathologies producing similar neuroimaging findings.
Probable diagnosis:
One major neuroimaging criterion plus any two clinical/exposure criteria
One minor neuroimaging criterion plus at least one major clinical/exposure criterion.
Separate diagnostic criteria for parenchymal and extraparenchymal neurocysticercosis have been suggested.[52]
World Health Organization (WHO): staging of cystic echinococcosis cysts[20][53]
Treatment options for cystic echinococcosis depend on the stage of development of the parasitic cyst based on ultrasound imaging. The classification applies to any cyst, except for osseous cysts, because it describes morphology.
Active cysts likely to contain viable protoscoleces
CE1
Active
Unilocular
Liquid content
Viable
Visible pathognomonic double wall sign
CE2
Active
Multivesicular
Liquid content
Viable
Visible pathognomonic honeycomb appearance (mother cyst filled with daughter cysts)
CE3a
Transitional unilocular
Liquid content with detached parasitic layers
Viable or non-viable
Visible pathognomonic water lily sign
CE3b
Active multivesicular
Partially solid content with daughter cysts
Viable
Visible pathognomonic Swiss cheese appearance
Inactive stages
CE4
Solid content
Unlikely to contain viable protoscoleces
Visible pathognomonic ball of wool or canalicular or cerebroid appearance
CE5
Solid content with eggshell calcified wall
Non-viable
Visible pathognomonic ball of wool or canalicular appearance
Cystic lesions
Not a cystic echinococcosis stage; indicates a cyst that could be a suspected young echinococcal cyst.
Unilocular with anechoic content without double wall sign or evident signs of non-parasitic aetiology.
Complicated cysts
A cyst with complications which might include rupture (outside, or internally in structures of the infected organ); cysts causing clinically significant compression of internal structures of the infected organ or of neighbouring organs, superinfection of the cyst with bacteria or fungi; and anaphylactic reactions to echinococcal antigens due to loss of integrity of the cyst wall.
Uncomplicated cysts
Cysts without complications.
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