Wang Qisheng, Hou Liming, Liu Liang
The Affiliated Hospital of Southwest Medical University, Department of Neurosurgery, Luzhou, China.
Turk Neurosurg. 2020;30(4):624-628. doi: 10.5137/1019-5149.JTN.22666-18.3.
To investigate the clinical manifestations and radiologic characteristics in diagnosing and treating hemorrhagic cerebral paragonimiasis.
The study retrospectively analyzed the data of three cases of hemorrhagic paragonimiasis who received treatment in the hospital from January 2014 to March 2017. All three patients were diagnosed with paragonimiasis by positive detection of paragonimiasis antibody. Based on the imaging data, the disease was confirmed as hemorrhagic cerebral paragonimiasis. One of the three patients was treated with oral praziquantel alone, one with praziquantel and thoracentesis, and one with praziquantel in combination with closed thoracic drainage and craniotomy.
All the lesions disappeared after computed tomography scan during the follow-up. Two of the three patients had no dysneuria, and one had mild dysneuria.
Hemorrhagic cerebral paragonimiasis should be diagnosed as early as possible using antibodies against paragonimiasis for patients with unexplained intracerebral hemorrhage, especially young patients with atypical imaging findings and multiple systemic lesions. It is possible to avoid craniotomy and improve the cure rate by the early, full-dose, and sufficient course of anti-parasitic treatment.
探讨出血性脑肺吸虫病的临床表现及影像学特征，以指导其诊断与治疗。
回顾性分析2014年1月至2017年3月在我院接受治疗的3例出血性肺吸虫病患者的数据。所有3例患者肺吸虫抗体检测均呈阳性，确诊为肺吸虫病。根据影像学资料，确诊为出血性脑肺吸虫病。3例患者中，1例仅接受口服吡喹酮治疗，1例接受吡喹酮及胸腔穿刺治疗，1例接受吡喹酮联合胸腔闭式引流及开颅手术治疗。
随访期间计算机断层扫描显示所有病灶均消失。3例患者中2例无神经功能障碍，1例有轻度神经功能障碍。
对于不明原因脑出血患者，尤其是影像学表现不典型且有多个系统病变的年轻患者，应尽早采用肺吸虫抗体进行诊断，以尽早发现出血性脑肺吸虫病。早期、足量、足疗程抗寄生虫治疗有可能避免开颅手术并提高治愈率。
