Abstract
Cerebral sparganosis is a severe parasitic infection caused by the larvae of Spirometra mansoni. We retrospectively reviewed the clinical data of 26 patients with cerebral sparganosis
diagnosed in our center and reviewed the literature on cerebral sparganosis in mainland
China. Among our 26 patients, 20 suffered from seizures, 11 had limb weakness and
11 experienced headaches. The characteristic MRI features included ring-like enhancement
in 24 patients, tunnel lesions in 14 patients and lesion migration in seven patients.
Twenty-three patients underwent surgery, with the brain tissues of all patients revealling
many inflammatory tunnels. Inside these tunnels, live or degenerate larvae were identified
in 20 patients, but only eosinophilic tunnels were identified in the three remaining
patients. All patients in this series received praziquantel, with three patients receiving
praziquantel alone, with no surgical intervention, and all had a favorable outcome
on long term follow-up. At least 82 patients with cerebral sparganosis with histo
pathological confirmation have been reported in mainland China. The clinical course,
radiological features, and pathological features of mainland Chinese patients were
mostly similar to those reported in other regions. There exists an inherent correlation
between radiological features and pathological changes, with worm migration causing
multiple inflammatory tunnels, especially eosinophilic tunnels, which thus form the
basis of tunnel-like or ring-like enhancement on multi-planar MRI, and might be predictors
for a poor prognosis. Surgical therapy is optimal in the treatment for cerebral sparganosis,
but medication (praziquantel and dexamethasone) has achieved favorable outcomes in
some patients.
Keywords
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Article info
Publication history
Accepted:
December 1,
2012
Received:
August 15,
2012
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
