Cysticercosis is a frequent parasitic infection in developing countries and is related to poverty, ignorance and pig rearing practices in community(1). Variety of structural involvement of central nervous system and orbit have been reported but cysticercus involving lateral sinus causing thrombosis is extremely rare.

A 13-year-male child presented with complaint of headache for 3 months. Headache was insidious in onset, localized to right temporal and frontal region and present throughout the day. There was no history of fever, vomiting, photophobia, blurring of vision, ear discharge, seizures and altered sensorium. Birth, developmental and family history were non contributory. On physical examination, patient was conscious and afebrile. His vitals were normal. Examination of ear, nose and throat was normal. Systemic examination was also normal. Ophthalmoscopy did not show evidence of raised intracranial pressure.

Hemoglobin, total and differential lecucocyte count were within normal range. Biochemical and cytological evaluation of the cerebrospinal fluid did not reveal any abnormality. CT scan of cranium showed small hypodense lesion in right lateral sinus with a hyperdense nodule within, suggestive of lateral sinus thrombosis. On MRI, right lateral sinus showed a small space occupying lesion with mixed intense signals on T1 and T2 with loss of flow void signals and reversal of blood flow and no significant enhancement with contrast. Examination of stool (three samples) did not reveal any ova or cyst. Patient was treated with albendazole (15 mg/kg/day) orally for 28 days. Patient was intensively monitored during first week and discharged. After 3 months, repeat CT and MRI of patient were normal.

Neurocysticercosis is common in developing countries, and is an important cause of epilepsy (9.1%) and hydrocephalus in children(1). Seizures (80-90%) are the most common neurological manifestations of symptomatic cysticercosis(2,3). The disease may also present with headache, chronic meningitis or symptoms of intracranial space occupying lesions(4). Isolated non-neurological manifestations such as ocular or dural cysts account for less than 5% of cases of symptomatic disease(5). Our case presented with headache, hitherto undescribed in literature. The noninvolvement of lateral sinus in neurocysticercosis may be due to high velocity of blood flow that prevents lodging of embryo in lateral sinus. MR venography is the ideal investigation for diagnosing such conditions.

1. Craig PS, Rogan MT, Allan JC. Detection, screening and community epidemiology of Tenia cestoda zoonoses: cystic echinococcosis and neurocysticercosis. Adv Parasitol 1996; 38: 169-250.

2. Salgado P, Rojas R, Sotelo J. Cysticercosis: Clinical manifestations based on imaging studies. Arch Intern Med 1997; 157: 1991-1997.

3. Leite JP, Terra-Bustamante VC, Fernandes RMF, Santos AC, Chimelli L, Sakamoto AC, et al. Calcified neurocysticercotic lesions and postsurgery seizure control in temporal lobe epilepsy. Neurology 2000; 55: 1485-1491.

4. Del Brutto OH. Neurocysticercosis. Curr Opin Neurol 1997; 10: 268-272.

5. Proano JV, Madrazo I, Avelar F, Lopez-Felix B, Diaz G, Grijalba I. Medical treatment for neurocysticercosis characterized by giant subarachnoid cysts. N Engl J Med 2001; 345: 879-885.