Isolated neurocysticercosis of the 4th ventricle presenting as Brun’s syndrome – A rare case

• Rare case of isolated fourth ventricular neurocysticercosis (NCC) • Patient presented with classical signs of Brun’s Syndrome due to CSF obstruction. • Successfully managed via a combination of CSF shunting and open microsurgical excision. • Histopathology confirmed classic features of *Taenia solium* cysticercus. • Post-operative recovery was complete with no recurrence on 6-month follow-up imaging. Neurocysticercosis (NCC) is the most common helminthic disease of the nervous system in humans and it is caused by the larvae of the pork tapeworm, Taenia solium. Isolated affection of any of the ventricles including the fourth ventricle is very uncommon. We present a case of microsurgical removal of a fourth ventricle NCC cyst via a suboccipital craniotomy in a 34-year-old male who presented with varying intensities of headache with change in position of the head due to obstructive hydrocephalus – characteristic of Brun’s Syndrome.