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出血性脑血管事件与神经囊尾蚴病:一例病例报告及文献综述

Hemorrhagic cerebrovascular events and neurocysticercosis: a case report and review of the literature.

作者信息

Viola George M, White A Clinton, Serpa Jose A

机构信息

Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

出版信息

Am J Trop Med Hyg. 2011 Mar;84(3):402-5. doi: 10.4269/ajtmh.2011.10-0429.

Abstract

Cerebrovascular complications have been reported to occur in patients with neurocysticercosis (NCC). We report a patient who presented with relapsed subarachnoid hemorrhage possibly linked to NCC. In addition, we performed a literature review of all of the reported cases of aneurysmal and non-aneurysmal hemorrhagic cerebrovascular events associated with NCC. We identified 11 such cases. The majority of the individuals were young males (mean: 38 years; 70% males). Four cases (36%) had aneurysms. Four (36%) others had negative cerebral angiograms and therefore classified as non-aneurysmal, while the remaining three (28%) did not report sufficient information to classify them. All cases with aneurysmal hemorrhage underwent successful surgical repair of the aneurysms. Seven patients received albendazole (including three who had had surgery). Three patients died; all three presented in the pre-albendazole era. In summary, neurocysticercosis should be considered in the differential diagnosis of hemorrhagic cerebrovascular events in young patients without classical vascular risk factors who have lived or visited NCC-endemic areas.

摘要

据报道,神经囊尾蚴病(NCC)患者会出现脑血管并发症。我们报告了一名患者,其复发性蛛网膜下腔出血可能与NCC有关。此外,我们对所有已报道的与NCC相关的动脉瘤性和非动脉瘤性出血性脑血管事件病例进行了文献综述。我们确定了11例此类病例。大多数患者为年轻男性(平均年龄:38岁;70%为男性)。4例(36%)有动脉瘤。另外4例(36%)脑血管造影结果为阴性,因此归类为非动脉瘤性,而其余3例(28%)未报告足够信息进行分类。所有动脉瘤性出血病例均成功进行了动脉瘤手术修复。7例患者接受了阿苯达唑治疗(包括3例已接受手术的患者)。3例患者死亡;这3例均出现在阿苯达唑时代之前。总之,对于没有经典血管危险因素、曾生活或到访过NCC流行地区的年轻患者,在出血性脑血管事件的鉴别诊断中应考虑神经囊尾蚴病。

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本文引用的文献

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Advances in the diagnosis and management of neurocysticercosis.神经囊尾蚴病的诊断与管理进展
Expert Rev Anti Infect Ther. 2006 Dec;4(6):1051-61. doi: 10.1586/14787210.4.6.1051.
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Inflammatory aneurysm due to neurocysticercosis.神经囊尾蚴病所致炎性动脉瘤。
J Clin Neurosci. 2005 Jun;12(5):585-8. doi: 10.1016/j.jocn.2004.07.018.
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Inflammatory aneurysm and neurocysticercosis: further evidence for a causal relationship? Case report.
Neurosurgery. 2000 Aug;47(2):466-7; discussion 467-8. doi: 10.1097/00006123-200008000-00042.
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J Neurol Sci. 1998 Jan 21;154(1):94-100. doi: 10.1016/s0022-510x(97)00206-2.
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