Bang O Y, Heo J H, Choi S A, Kim D I
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Stroke. 1997 Jan;28(1):211-3. doi: 10.1161/01.str.28.1.211.
Large cerebral infarction is a rare complication of neurocysticercosis. Endarteritis by inflammation of the leptomeninges is known to be its cause.
A 59-year-old man with known neurocysticercosis developed a large cerebral infarction during praziquantel therapy. A follow-up MRI obtained immediately after his cerebral infarction demonstrated notable decrease in the size of the cysts and more prominent enhancement around the peripheral margins of the cysts and the major vessels in comparison with the initial MRI. Cerebral angiography disclosed occlusions and narrowing of both internal carotid arteries at the supraclinoid portions, where multiple cysts were found on the MRI.
Findings in our patient strongly suggest that a secondary inflammation reaction caused by the destruction of the cysts might have enhanced the process of endarteritis. The possible deleterious effects of praziquantel therapy should be considered in the treatment of patients with subarachnoid cysticerci.
大脑大面积梗死是神经囊尾蚴病的一种罕见并发症。已知软脑膜炎症引起的动脉内膜炎是其病因。
一名患有神经囊尾蚴病的59岁男性在吡喹酮治疗期间发生了大脑大面积梗死。脑梗死后立即进行的随访磁共振成像（MRI）显示，与初始MRI相比，囊肿大小显著减小，囊肿周边及主要血管周围强化更明显。脑血管造影显示双侧颈内动脉床突上段闭塞和狭窄，MRI上在该部位发现多个囊肿。
我们患者的检查结果强烈提示，囊肿破坏引起的继发性炎症反应可能加剧了动脉内膜炎进程。在治疗蛛网膜下腔囊尾蚴病患者时应考虑吡喹酮治疗可能产生的有害影响。
