**4. Pathological features in neurocysticercosis**

The pathological features of NCC depend on the infection's stage and the cysticerci's location within the central nervous system. The cysticerci reach the CNS through the bloodstream or lymphatic system. They can penetrate the blood-brain barrier and disseminate throughout the brain or spinal cord. The most common sites of cysticercosis formation in NCC include the brain parenchyma, ventricular system, subarachnoid space, and, rarely, the spinal cord [1, 14, 19, 28–31].

#### **4.1 Tissue damage**

While the inflammatory response is aimed at controlling the infection, it can also contribute to tissue damage and neuropathology in NCC. The presence of immune cells and the release of inflammatory mediators can lead to the destruction of surrounding CNS tissue, disruption of the blood-brain barrier, and the release of toxic molecules. This tissue damage can result in clinical manifestations and neurological deficits [19, 28, 29, 31, 32].

#### **4.2 Perilesional edema**

Inflammation in NCC can lead to perilesional edema, the swelling of the tissue surrounding the cysticerci. Perilesional edema is attributed to increased vascular permeability, disrupted blood-brain barrier, and alterations in the balance of fluid regulation within the CNS. It can contribute to neurological symptoms and complications [14, 19, 28, 29, 31].

In some cases, NCC can lead to inflammation of the blood vessels in the brain, resulting in vasculitis. Vasculitis can cause disruption of the blood-brain barrier, leading to edema (swelling) and potentially causing neurological complications [19, 29, 31].

#### **4.3 Neurological complications**

The inflammatory response and associated neuropathology in NCC can lead to neurological complications. These complications may include seizures, focal neurological deficits, cognitive impairments, hydrocephalus, vasculitis, and increased intracranial pressure. Apart from these findings, meningoencephalitis and psychoses are among the common pathology [33]. The severity and extent of these complications depend on factors such as the number and location of cysticerci, the host's immune response, and individual susceptibility [19, 28, 29, 31].

Understanding the relationship between the inflammatory response and neuropathology in NCC is crucial for comprehending the disease progression, developing therapeutic strategies, and managing neurological complications. The modulation of the inflammatory response and targeted interventions may hold promise for improving outcomes in NCC.

Spinal cysticercosis, although rare, can manifest as a cause of myelopathy, a neurological disorder affecting the spinal cord. The characteristic MRI features observed in affected individuals facilitate the recognition and accurate diagnosis of spinal cysticercosis. Therefore, clinicians must include spinal cysticercosis in the differential diagnosis when evaluating patients with myelopathy symptoms. In cases where spinal cysticercosis is confirmed, the recommended course of treatment involves the

### *Neurocysticercosis: An Overview of Pathology and Pathogenesis DOI: http://dx.doi.org/10.5772/intechopen.113237*

complete resection of the causative lesion and the administration of oral albendazole, an antiparasitic medication. This combined therapeutic approach has shown promising results, leading to the regression of symptoms in patients with spinal cysticercosis. Histopathological examination plays a crucial role in establishing the definitive diagnosis of spinal cysticercosis. By analyzing tissue samples obtained during surgical intervention, the characteristic features of the condition, such as the presence of parasitic larvae, can be identified. This histopathological confirmation not only confirms the diagnosis of spinal cysticercosis but also aids in differentiating it from other potential causes of spinal space-occupying lesions. In summary, recognizing spinal cysticercosis as a rare cause of myelopathy is aided by the characteristic MRI features observed in affected individuals. Clinicians should actively consider spinal cysticercosis during the differential diagnosis of myelopathy cases. When confirmed, complete resection of the causative lesion, coupled with oral albendazole administration, has demonstrated positive outcomes in symptom regression. Furthermore, the importance of histopathological examination cannot be understated, as it provides definitive confirmation of the diagnosis and aids in differentiating spinal cysticercosis from other spinal space-occupying lesions [34].
