Department of Neurosurgery, Faculty of Medical Science of Minas Gerais, Minas Gerais, Brazil.
World Neurosurg. 2011 Jul-Aug;76(1-2):200-7; discussion 84-6. doi: 10.1016/j.wneu.2010.12.002.
To describe published cases of cerebral mansoni schistosomiasis and three others and discuss the diagnosis and treatment of cerebral pseudotumoral schistosomiasis.
In case 1, a 20-year-old man presented with occipital headache, intense dizziness, visual alterations, nausea, decreased appetite, and asthenia. Cranial computed tomography (CT) revealed an expansive cerebellar lesion in the right hemisphere with no contrast enhancement. The patient had complete resection of the lesion. Anatomicopathological examination revealed a schistosomal granuloma. In case 2, a 22-year-old man presented with generalized tonic-clonic seizure. Cranial CT and magnetic resonance imaging (MRI) revealed an expansive bilateral middle frontal lesion, with contrast uptake close to the cingulate gyrus and corpus callosum. The patient underwent left frontal craniotomy, and an interhemispheric approach was used to resect part of the lesion. In case 3, a 32-year-old man presented with generalized tonic-clonic seizures. Cranial CT showed a hyperdense intense intracranial expansive lesion that presented contrast uptake in the left temporal region. The patient had complete resection of the lesion.
A surgical approach with lesion resection or stereotaxic biopsy is warranted to determine the diagnosis definitively. Antiparasitic drugs must be administered to complete treatment.
描述已发表的脑曼氏血吸虫病病例和另外 3 例病例，并讨论脑假性脑瘤型血吸虫病的诊断和治疗。
在病例 1 中，一名 20 岁男性出现枕部头痛、剧烈头晕、视力改变、恶心、食欲不振和乏力。头颅计算机断层扫描（CT）显示右侧半球有一个扩张性小脑病变，无对比增强。患者行病变完全切除术。解剖病理学检查显示为血吸虫性肉芽肿。在病例 2 中，一名 22 岁男性出现全身强直阵挛性发作。头颅 CT 和磁共振成像（MRI）显示双侧额中回扩张性病变，对比摄取靠近扣带回和胼胝体。患者行左额开颅术，并采用大脑间入路切除部分病变。在病例 3 中，一名 32 岁男性出现全身强直阵挛性发作。头颅 CT 显示高密度、强烈的颅内扩张性病变，左侧颞区有对比摄取。患者行病变完全切除术。
手术切除或立体定向活检以明确诊断是必要的。必须给予抗寄生虫药物以完成治疗。
