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表现为锁定性侧脑室的神经囊尾蚴病:一例报告及循证综述

Neurocysticercosis presenting as a locked-in lateral ventricle: A case report and evidence-based review.

作者信息

Mansour Moustafa A, Tahir Mohamed, Ahmadi Zarina

机构信息

Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Department of Neurology and Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.

出版信息

IDCases. 2023 Apr 27;32:e01778. doi: 10.1016/j.idcr.2023.e01778. eCollection 2023.

Abstract

Human neurocysticercosis is one of the most prevalent parasitic infestations of the central nervous system. It is considered the most frequent underlying etiology of acquired epilepsy in endemic areas in Central and South America, East Europe, Africa, and Asia, with over 50 million people affected globally. Ventricular involvement is a severe form of neurocysticercosis commonly manifests as arachnoiditis, raised intracranial pressure, or hydrocephalus, secondary to CSF flow obstruction of the ventricular system by cysts of , hence requiring prompt, aggressive intervention to alleviate the increased intracranial pressure to prevent imminent lethal complications. Ventricular neurocysticercosis can involve any brain ventricle but with a paramount preference for the fourth ventricle, causing non-communicating hydrocephalus and symmetric ventriculomegaly. However, in this clinical report, we present an uncommon case of trapped (locked-in) lateral ventricle caused by an isolated cysticercus trapped at the ipsilateral foramen of Monro, which is an atypical location for neurocysticercosis, adding more challenges to diagnosis and during the process of surgical extraction. We additionally provide a comprehensive, evidence-based review of the clinical course and management options relevant to the entity of ventricular neurocysticercosis, besides recent relevant clinical updates.

摘要

人类神经囊尾蚴病是中枢神经系统最常见的寄生虫感染之一。它被认为是中南美洲、东欧、非洲和亚洲流行地区后天性癫痫最常见的潜在病因,全球有超过5000万人受其影响。脑室受累是神经囊尾蚴病的一种严重形式,通常表现为蛛网膜炎症、颅内压升高或脑积水,继发于脑室系统的脑脊液流动因囊肿阻塞,因此需要迅速、积极的干预以减轻颅内压升高,防止即将出现的致命并发症。脑室神经囊尾蚴病可累及任何脑室,但最常累及第四脑室,导致非交通性脑积水和对称性脑室扩大。然而,在本临床报告中,我们介绍了一例罕见的被困(闭锁)侧脑室病例,由一个孤立的囊尾蚴被困在同侧的孟氏孔引起,这是神经囊尾蚴病的非典型位置,给诊断和手术摘除过程增加了更多挑战。除了近期的相关临床进展外,我们还对与脑室神经囊尾蚴病实体相关的临床病程和管理选择进行了全面的、基于证据的综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9930/10267758/135ac31868f6/gr1.jpg

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