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脊髓硬膜内髓外神经囊尾蚴病:一例报告

Spinal Intradural-Extramedullary Neurocysticercosis: A Case Report.

作者信息

Fonseca João M, Borba Lucca R, Chiaretti Ana S, Resende Marilia C, Fonseca Junior Luciano E

机构信息

Radiology, University of Florida, Gainesville, USA.

Internal Medicine, Hospital Universitário Professor Edgard Santos, Salvador, BRA.

出版信息

Cureus. 2025 May 19;17(5):e84397. doi: 10.7759/cureus.84397. eCollection 2025 May.

Abstract

Neurocysticercosis is a parasitic infection of the central nervous system (CNS) caused by the larval stage of the tapeworm. This condition is most commonly characterized by the development of cysts in the intracranial CNS, causing a wide range of neurological symptoms, such as seizures, headaches, and signs of increased intracranial pressure. Spinal intradural-extramedullary neurocysticercosis is a rare extracranial form of the disease that often resembles other conditions, such as arachnoid cysts or spinal tumors. We report the case of a 55-year-old man from Bahia, Brazil, who experienced chronic urinary retention, lower back pain, and bilateral leg tingling. Original MRI scans suggested multiple arachnoid cysts, but further imaging indicated neurocysticercosis as a possible diagnosis. The patient underwent T12-S1 laminectomy, where cystic lesions were identified and biopsied. Histopathology, posteriorly, confirmed the final diagnosis of neurocysticercosis, showing areas of necrosis and calcifications and viable parasite structures. After surgery, the patient still presented mild symptoms, such as constipation and left leg paresthesia. This case highlights the challenges of spinal neurocysticercosis diagnosis. We emphasize the importance of considering it in the differential diagnosis of spinal cystic lesions, especially in areas where the disease is common.

摘要

神经囊尾蚴病是一种由绦虫幼虫阶段引起的中枢神经系统(CNS)寄生虫感染。这种疾病最常见的特征是颅内中枢神经系统出现囊肿,导致一系列广泛的神经症状,如癫痫发作、头痛和颅内压升高的体征。脊髓硬膜内-髓外神经囊尾蚴病是一种罕见的颅外形式的疾病,通常类似于其他病症,如蛛网膜囊肿或脊髓肿瘤。我们报告了一例来自巴西巴伊亚州的55岁男性病例,该患者经历了慢性尿潴留、下背部疼痛和双侧腿部刺痛。最初的磁共振成像(MRI)扫描提示多个蛛网膜囊肿,但进一步的影像学检查表明神经囊尾蚴病可能是诊断结果。患者接受了T12-S1椎板切除术,术中发现囊性病变并进行了活检。组织病理学检查最终证实为神经囊尾蚴病,显示出坏死和钙化区域以及存活的寄生虫结构。手术后,患者仍有便秘和左腿感觉异常等轻度症状。该病例突出了脊髓神经囊尾蚴病诊断的挑战。我们强调在脊髓囊性病变的鉴别诊断中考虑该病的重要性,尤其是在该病常见的地区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e9a/12175642/b2352396adb1/cureus-0017-00000084397-i01.jpg

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