Yang S Y, Wang M L, Xue Q C
Department of Neurosurgery, Tianjin Medical College Hospital, People's Republic of China.
Surg Neurol. 1990 Nov;34(5):286-93. doi: 10.1016/0090-3019(90)90003-8.
We studied 143 cases of cerebral cysticercosis over a 30-year period. In 46 there was hydrocephalus due to cysts obstructing the cerebrospinal fluid pathways, with signs of hydrocephalus and cerebellar dysfunction. In 97 there were cysts in the cerebral parenchyma, causing symptoms of intracranial hypertension alone in 22 cases, with additional neurological deficits in the remainder. Before 1980 diagnosis was made by pneumoencephalography and ventriculography, but since then it has mostly been done by computed tomography. In 28 cases scanned, typical abnormalities were present in 25. Complement fixation tests were positive in serum in 74% of cases and in cerebrospinal fluid in 73%, and the enzyme-linked immunosorbent assay test was positive in serum in 90% and in cerebrospinal fluid in 92%. Treatment of cases with hydrocephalus was by removal of the cysts at craniotomy, with placement of a shunt where necessary. Intracranial hypertension caused by parenchymal cysts was treated with steroids and osmotic agents, if possible. In resistant cases subtemporal decompression was needed, unilateral in 55 cases and bilateral in eight. Mortality in the acute stage was 11%, with a further 20% at follow up.
我们在30年期间研究了143例脑囊尾蚴病。46例因囊肿阻塞脑脊液通路而出现脑积水，伴有脑积水和小脑功能障碍的体征。97例脑实质中有囊肿，22例仅出现颅内高压症状，其余伴有其他神经功能缺损。1980年前通过气脑造影和脑室造影进行诊断，但此后大多通过计算机断层扫描进行诊断。在28例扫描病例中，25例有典型异常。补体结合试验血清阳性率为74%，脑脊液阳性率为73%；酶联免疫吸附试验血清阳性率为90%，脑脊液阳性率为92%。脑积水病例通过开颅手术切除囊肿治疗，必要时放置分流管。实质性囊肿引起的颅内高压，尽可能用类固醇和渗透性药物治疗。在耐药病例中，需要进行颞下减压，55例单侧减压，8例双侧减压。急性期死亡率为11%，随访时另有20%死亡。
