Mackenzie I R, Guha A
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
J Neurosurg. 1998 Dec;89(6):1052-4. doi: 10.3171/jns.1998.89.6.1052.
Neurological complications arising from schistosomiasis are uncommon, and reports of Manson's schistosomiasis presenting as an intracerebral mass lesion are particularly rare. The authors describe the case of a 26-year-old man with a 3-month history of headaches and visual abnormalities. He had immigrated to Canada from Brazil 4 years previously. The patient's general physical and neurological examinations were unremarkable. Magnetic resonance (MR) imaging revealed an enhancing lesion with surrounding edema and mild mass effect in the right occipital lobe. A stereotactic brain biopsy demonstrated intraparenchymal granulomas surrounding Schistosoma masoni eggs. The patient's symptoms resolved following treatment with praziquantel and steroid medications; follow-up MR imaging yielded normal findings. This case demonstrates that neuroschistosomiasis should be considered when an individual presenting with an intracerebral mass has lived in a region in which this disease is endemic.
血吸虫病引起的神经系统并发症并不常见，而曼氏血吸虫病表现为脑内肿块病变的报道尤为罕见。作者描述了一名26岁男性的病例，该患者有3个月的头痛和视觉异常病史。他4年前从巴西移民到加拿大。患者的全身体格检查和神经系统检查均无异常。磁共振成像显示右枕叶有一个强化病变，周围有水肿和轻度占位效应。立体定向脑活检显示脑实质内有围绕曼氏血吸虫卵的肉芽肿。患者在接受吡喹酮和类固醇药物治疗后症状缓解；随访磁共振成像结果正常。该病例表明，当出现脑内肿块的个体曾生活在该病流行地区时，应考虑神经血吸虫病。
