1 Am. J. Trop. Med. Hyg., 85(1), 2011, pp. 1–2 doi:10.4269/ajtmh.2011.10-0731 Copyright © 2011 by The American Society of Tropical Medicine and Hygiene Neurocysticercosis is of emerging importance in the United States because of immigration from disease-endemic regions of Latin America. 1 Intraventricular neurocysticercal cysts are probably more frequent than previously thought and usually occur as single cysts in the fourth ventricle or as multiple cysts that frequently coexist with parenchymal and sub-arachnoid cysts. 2 However, multiple intraventricular cysts without accom- panying visible parenchymal cysts are a relatively uncommon manifestation of neurocysticercosis, and it remains unclear if endoscopic removal of these cysts is adequate without anti- parasitic therapy. A 41-year-old man (Mexican immigrant) had headache of two-months duration. Results of brain imaging and immuno- logic studies were suggestive of intraventricular neurocysticer- cosis and three cysts were identified (Figures 1 and 2). There were no parenchymal cysts. Surgical removal of the cysts with flexible endoscopy resulted in resolution of symptoms. The patient received corticosteroids for three weeks but no anti- parasitic treatment. After one-year follow-up, he remained asymptomatic without any cysts when examined by repeat neuroimaging (Figure 3). Images in Clinical Tropical Medicine Multiple Intraventricular Neurocysticercal Cysts Treated with Endoscopy without Antiparasitic Therapy Theodoros Kelesidis* and Nguyen Thian Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California; Department of Surgery, University of California School of Medicine, Los Angeles, California * Address correspondence to Theodoros Kelesidis, Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA 90095. E-mail: tkelesidis@med net.ucla.edu Figure 2. Magnetic resonance imaging of the brain (transverse view) of the patient showing two right intraventricular and one left intraventricular cystic lesions at varying stages. There is a larger 2.3-cm lesion in the posterior aspect of the right ventricle, which follows fluid signal on all sequences. There is subtle mass effect of the right ven- tricle, which appears asymmetrically enlarged compared with the left ventricle. There is no obstructing lesion in the region of the foramen of Monro or third ventricle. No parenchymal lesions were identified. Figure 1. Computed tomography of the head of the patient with- out contrast showing two right intraventricular and one left intraven- tricular cystic lesions.