[Cerebral schistosomiasis with a huge calcification. A case report].

A case of cerebral schistosomiasis with a huge calcification and with a long clinical course was reported. A 39-year-old male developed ataxic gait gradually associated with headache and general fatigability. According to the past history, the patient had suffered from severe meningitis with disturbance of consciousness for 2 weeks when he was 10 years of age. Neurological examination revealed positive Romberg's sign and left homonymous hemianopsia. Plain craniogram showed a large calcification occupying the whole right occipital region. This calcification was lobulated in shape and was 11 X 9 X 9 cm in size. CT scan demonstrated calcification and remarkable hydrocephalus. This calcification had no mass effect. Left vertebral angiogram revealed the right parieto-occipital artery to be stretched and slightly displaced toward midline. Hematological analysis disclosed no abnormality except for eosinophilia (10%). Pre-operative diagnosis was an old calcified granuloma of unknown origin. For the purpose of biopsy, a right occipital craniotomy was performed. On reflecting the dura, fibrous adhesion and vascular network were seen between the inner table of the dura and the arachnoid. Subarachnoid space was enlarged and all cortical vessels were narrow in their diameters. By a corticotomy, a whitish-yellow calcified mass was seen in the depth of 2 mm. The yellowish gelatinous content poured out of the mass. A piece of calcification and a small amount of content were taken as specimen. Microscopic study of the calcified tissue showed many egg shells of schistosoma japonica, necrotic tissues and infiltration of small round cells.