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[一例传播途径不明的孤立性神经囊尾蚴病病例]

[A case of solitary neurocysticercosis of unknown transmission route].

作者信息

Matsunaga Shigeo, Asada Hiroyuki, Shuto Takashi, Hamada Kouichi, Inomori Shigeo, Kawamura Shunji, Hamada Atsurou, Okuzawa Eiichi

机构信息

Department of Neurosurgery, Yokohama Rosai Hospital.

出版信息

No Shinkei Geka. 2002 Nov;30(11):1223-8.

Abstract

We report a case of solitary neurocysticercosis of unknown transmission route. A 26-year-old male was taken to our hospital with a history of general convulsions. On admission, physical and neurological findings were normal. On the basis of neuroimaging (computed tomography scan and magnetic resonance imaging), initial diagnosis was brain abscess and the patient was treated with antibiotics. Two months later, the patient, at times, presented a loss of consciousness. The follow-up MRI revealed that the enhanced lesion became enlarged and perifocal edema became evident, so the patient was surgically treated. By histopathological examination, the lesion was diagnosed as a cysticercus. The immunoserologic assay gave a positive result for the disease. Postoperatively, the symptoms improved. Cerebral cysticercosis is the most common parasitic disease of the central nervous system, but rare in Japan. Therefore its diagnosis remains difficult, especially in the case of solitary cerebral cysticercosis, which has been reported only 7 times in Japan. The pathological examination or the immunoserologic assay should be taken into consideration to obtain definitive diagnosis of cerebral cysticercosis.

摘要

我们报告一例传播途径不明的孤立性神经囊尾蚴病病例。一名26岁男性因全身性惊厥病史被送至我院。入院时,体格检查和神经系统检查结果均正常。基于神经影像学检查(计算机断层扫描和磁共振成像),初步诊断为脑脓肿,患者接受了抗生素治疗。两个月后,患者有时会出现意识丧失。后续的磁共振成像显示强化病变增大,病灶周围水肿明显,因此对患者进行了手术治疗。通过组织病理学检查,病变被诊断为囊尾蚴。免疫血清学检测对该疾病呈阳性结果。术后症状有所改善。脑囊尾蚴病是中枢神经系统最常见的寄生虫病,但在日本较为罕见。因此其诊断仍然困难,尤其是孤立性脑囊尾蚴病的情况,在日本仅报道过7例。为明确脑囊尾蚴病的诊断,应考虑进行病理检查或免疫血清学检测。

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