Vatsal Devendra K, Kapoor Shalini, Venkatesh Vimala, Vatsal Priti, Husain Nuzhat
K. K. Hospital, Lucknow, India.
Neurosurgery. 2006 Sep;59(3):E706-7; discussion E706-7. doi: 10.1227/01.NEU.0000230247.42067.6C.
Parasitic myelopathy is rare. We report ectopic infestation of the spine by Fasciola hepatica.
A young woman presented with gradual onset paraplegia with bladder and bowel involvement. A magnetic resonance imaging scan showed an epidural mass lesion that was isotense on T1-weighted images and hyperintense on T2-weighted images, extending from T4-T7 vertebra with extradural cord compression. She was diagnosed with cord compression, possibly owing to tubercular epidural granulation tissue.
During surgery, a mobile, flat, leaf-like, pink parasite was found in the epidural space. Morphological and histological indices confirmed the parasite as Fasciola hepatica.
Ectopic spinal localization of Fasciola may occur during the transmigration path of the parasite through peritoneum or from the liver through portal venous system.
寄生虫性脊髓病较为罕见。我们报告了1例肝片吸虫在脊柱的异位寄生情况。
一名年轻女性逐渐出现截瘫，并伴有膀胱和肠道受累。磁共振成像扫描显示硬膜外有一肿块病变，在T1加权图像上呈等密度，在T2加权图像上呈高信号，从T4至T7椎体延伸，伴有硬膜外脊髓受压。她被诊断为脊髓受压，可能是由于结核性硬膜外肉芽组织所致。
手术过程中，在硬膜外间隙发现了一个可移动的、扁平的、叶状的粉红色寄生虫。形态学和组织学指标证实该寄生虫为肝片吸虫。
肝片吸虫的异位脊柱定位可能发生在寄生虫通过腹膜的移行路径中，或从肝脏通过门静脉系统移行时。
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