A 39-year old male immigrant from Mexico with no past medical history of seizure presented to the ED for concerns of head trauma secondary to assault. Patient reported only mild headache and facial bruising. Review of neurological history showed no cognitive dysfunction, weakness, numbness, or bowel or urinary incontinence. At presentation vitals were stable. Primary and secondary trauma survey was inconclusive.

Neurologic exam was grossly intact, no focal neurologic deficits were identified. CT head showed chronic multiple cystic lesions with calcifications consistent with NCC. MRI brain showed calcifications on SWIp alongside findings consistent with giant PVSs. Serum ELISA anti-cysticercosis antibodies were negative. Confirmatory Western-blot of anti-cysticercosis IgG was sent.

Based on history and imaging, the patient was diagnosed with NCC with radiographic presence of giant PVSs. Treatment regimen consisting of albendazole, praziquantel, and prednisone was given for 10 days.

Outcome: Treatment was stopped after patient showed clinical and radiographic improvement