Zapata Carlos Hugo, Vargas Sergio Alberto, Uribe Carlos Santiago
Sección de Neurología, Departamento de Medicina Interna, Hospital Universitario de San Vicente Fundación, Universidad de Antioquia, Medellín, Colombia.
Biomedica. 2017 Apr 1;37(0):26-32. doi: 10.7705/biomedica.v37i2.2983.
Neurocysticercosis is the leading cause of parasitosis of the central nervous system and acquired epilepsy in developing countries. The clinical manifestations of neurocysticercosis, especially its racemose variant, are pleomorphic and unspecific, characteristics that hinder the diagnosis and make it a challenge for the clinician.The objective of this report was to describe two cases of racemose neurocysticercosis in which neuroimaging led to the definitive diagnosis. The first case involved a patient with persistent headache and focal neurological signs. She required multiple paraclinical tests that led to the definitive diagnosis of racemose neurocysticercosis with secondary cerebral vasculitis. Despite medical and surgical treatment the patient died after multiple complications.The second case involved a patient with a history of neurocysticercosis, who consulted for chronic intractable vomiting. She required multiple paraclinical tests that led to the diagnosis of vomiting of central origin secondary to racemose neurocysticercosis and entrapment of the fourth ventricle. After medical and surgical treatment the patient showed slight improvement. In these two cases it was evident how proper interpretation of neuroimages is essential for the diagnosis of racemose neurocysticercosis.
神经囊尾蚴病是发展中国家中枢神经系统寄生虫病和后天性癫痫的主要病因。神经囊尾蚴病的临床表现,尤其是其葡萄状变种,具有多形性且不具特异性,这些特征阻碍了诊断,对临床医生来说是一项挑战。本报告的目的是描述两例葡萄状神经囊尾蚴病病例,其中神经影像学检查得出了明确诊断。第一例病例涉及一名患有持续性头痛和局灶性神经体征的患者。她需要进行多项辅助检查,最终确诊为葡萄状神经囊尾蚴病继发脑动脉炎。尽管接受了药物和手术治疗,该患者还是在出现多种并发症后死亡。第二例病例涉及一名有神经囊尾蚴病病史的患者,因慢性顽固性呕吐前来就诊。她需要进行多项辅助检查,最终诊断为葡萄状神经囊尾蚴病继发中央性呕吐及第四脑室受压。经过药物和手术治疗后,该患者有轻微改善。在这两例病例中,很明显对神经影像的正确解读对于葡萄状神经囊尾蚴病的诊断至关重要。