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一名患有急性脊髓病儿童的髓内脊髓血吸虫病:病例报告

Intramedullary spinal schistosomiasis in a child with acute myelopathy: A case report.

作者信息

Rodrigues Daniella Brito, Rodrigues Anderson Batista, Queiroz Joao Welberthon Matos, Braga Murillo Cunegatto, Kita William Seiti, Netto Ricardo Henrique Doria, de Souza Rafael Wilson, Napoli Paulo Roberto, de Luna Allexsandro Aparecido Alvarenga Nascimento Faria

机构信息

Department of Neurosurgery, Santa Marcelina Hospital, Sao Paulo, Brazil.

出版信息

Surg Neurol Int. 2020 Nov 6;11:371. doi: 10.25259/SNI_484_2020. eCollection 2020.

Abstract

BACKGROUND

Neuroschistosomiasis is defined as an infection of the nervous system caused by . Neuroschistosomiasis is an important differential diagnostic consideration in pediatric patients presenting with myelopathy. Surgical excision combined with antiparasitic drugs typically provides a satisfactory outcome and often results in neurological recovery.

CASE DESCRIPTION

A 4-year-old child presented with acute and progressive myelopathy. A thoracolumbar magnetic resonance image revealed a T12-L2 conus medullaris mass that was isointense on T1 and hyperintense on T2 (with an extensive syringomyelia at the thoracic spinal cord) and showed enhanced heterogeneity with gadolinium. The lesion was excised through T12-L2 laminotomy. Intraoperatively, the tumor appeared reddish and infiltrative. The frozen section suggested a granulomatous process, while the final pathology confirmed conus medullaris schistosomiasis.

CONCLUSION

Schistosomal myeloradiculopathy should be considered among the different diagnosis in children presenting with lower thoracic region, conus medullaris, and/or cauda equina infiltrative spinal masses.

摘要

背景

神经血吸虫病被定义为由……引起的神经系统感染。神经血吸虫病是患有脊髓病的儿科患者重要的鉴别诊断考虑因素。手术切除联合抗寄生虫药物通常能取得满意的结果,且常常能实现神经功能恢复。

病例描述

一名4岁儿童出现急性进行性脊髓病。胸腰椎磁共振成像显示T12 - L2脊髓圆锥有一肿块,在T1加权像上呈等信号,在T2加权像上呈高信号(胸段脊髓有广泛的脊髓空洞症),钆增强后显示不均匀强化。通过T12 - L2椎板切开术切除病变。术中,肿瘤呈红色且具有浸润性。冰冻切片提示为肉芽肿性病变,而最终病理证实为脊髓圆锥血吸虫病。

结论

对于出现下胸段、脊髓圆锥和/或马尾浸润性脊髓肿块的儿童,在鉴别诊断中应考虑血吸虫性脊髓神经根病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e96/7771502/26cf265ea00a/SNI-11-371-g001.jpg

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