1/9. Radiologic-pathologic findings in raccoon roundworm (Baylisascaris procyonis) encephalitis. A 13-month-old boy developed eosinophilic meningoencephalitis, retinitis, and a protracted encephalopathy with severe residual deficits. The initial MR examination revealed diffuse periventricular white matter disease, and follow-up images showed atrophy. brain biopsy, serology, and epidemiologic studies lead to the diagnosis of Baylisascaris procyonis infection, a parasitic disease contracted through exposure to soil contaminated by the eggs of a common raccoon intestinal roundworm. The pathologic, epidemiologic, and imaging features of this disease are herein reviewed. ( info) |
2/9. A case of eosinophilic meningitis. A case of eosinophilic meningitis is reported, a condition not previously reported from sri lanka. We propose angiostrongylus cantonesis to be the most likely causative agent in this patient. ( info) |
3/9. Gigantic intracranial mass of hydatid cyst. A child (8 years old) with a gigantic mass of intracranial hydatid cysts (95x90x75 mm) is presented. The first manifestation was difficulty in walking, which was followed by symptoms of raised intracranial pressure. A craniotomy was performed, and more than 25 hydatid cysts were removed. The literature is reviewed and the incidence of gigantic mass of cerebral hydatid cyst is compared in the published reports. ( info) |
4/9. A large cerebral hydatid cyst associated with liver cyst. Hydatid disease in childhood is a serious health problem in turkey and other places where the parasite is endemic. An 8-year-old girl from a rural area was admitted with headache, recurrent abdominal pain, abdominal distension and hypo-aesthesia and paresis of the right arm. Computerised tomography (CT) scans demonstrated a large intracranial hydatid cyst. A hydatid cyst was detected in the liver also. Her mother had been treated previously for disseminated hydatid disease. The cerebral cyst was removed but only subtotal excision of the hepatic cyst was possible. She was treated with albendazole, has fully recovered and, after 12 months of follow-up, there is no sign of recurrence. ( info) |
5/9. MR imaging findings in cerebrospinal gnathostomiasis. Human gnathostomiasis is an infection caused mainly by gnathostoma spinigerum, a nematode. Infected humans can present with various clinical manifestations. serology is the criterion standard for diagnosing gnathostomiasis, whereas MR imaging represents a complementary tool for assessing severity and extent of disease. We report two definite cases of gnathostomiasis that were confirmed by the immunoblotting technique. MR imaging of the cervical cords showed cord enlargement and diffuse high signal intensity, mainly of the gray-white matter regions. MR imaging of the brain showed hemorrhagic tract and scattered deep intracerebral hemorrhage with diffuse, fuzzy white matter lesions with nodular enhancement. Severe gnathostomiasis was unresponsive to treatment. ( info) |
| Clinical involvement of the nervous system in visceral larva migrans due to toxocara is rare, although in experimental animals the larvae frequently migrate to the brain. A review of the literature from the early 50's to date found 29 cases of brain involvement in toxocariasis. In 20 cases, various clinical and laboratory manifestations of eosinophilic meningitis, encephalitis, myelitis or radiculopathy were reported. We report two children with neurological manifestations, in which there was cerebrospinal fluid pleocytosis with marked eosinophilia and a positive serology for toxocara both in serum and CSF. serology for schistosoma mansoni, cysticercus cellulosae, toxoplasma and cytomegalovirus were negative in CSF, that was sterile in both cases. Improvement of signs and symptoms after specific treatment (albendazole or thiabendazole) was observed in the two cases. A summary of data described in the 25 cases previously reported is presented and we conclude that in cases of encephalitis and myelitis with cerebrospinal fluid pleocytosis and eosinophilia, parasitic infection of the central nervous system should be suspected and serology should be performed to establish the correct diagnosis and treatment. ( info) |
7/9. Primary multiple intracerebral echinococcosis in a young child. Primary multiple intracerebral echinococcosis is a very rare disorder particularly in children. In this case report we discuss the details of clinical presentation and management in a young child. We also highlight for the first time non-iatrogenic 'water lily' appearance of the lesion on computed tomography of the head. ( info) |
8/9. diffusion-weighted and conventional MR imaging in neurotrichinosis. central nervous system involvement in trichinosis is not rare. brain lesions in trichinosis have been defined on computed tomography and magnetic resonance imaging (MRI) as multifocal small lesions located in the cerebral cortex and white matter. We present a case of trichinosis with multifocal lesions of the brain detected by MRI and diffusion weighted MRI. Evolutions of these lesions from acute through chronic stages on follow up studies are also presented. This is the first report describing sequential MRI findings and diffusion weighted imaging appearance of brain lesions in trichinosis. Sequential evaluation of conventional and diffusion MR data allowed us to conclude that multifocal lesions in the brain were related to multiple infarctions rather than true inflammatory infiltration of the brain parenchyma. ( info) |
9/9. Surgical removal of a live worm by stereotactic targeting in cerebral sparganosis. Case report. A 64-year-old man presented with generalized tonic clonic convulsion followed by weakness of the right lower extremity. He had a medical history of hypertension, hyperlipidemia, and right cerebellar infarction. Computed tomography (CT) showed a small high density nodule with an enhanced perifocal low density area in the left occipital lobe. T1-weighted magnetic resonance (MR) imaging showed a ring-shaped and partial string-like nodule with enhancement by gadolinium. T2-weighted MR imaging showed the white matter of the left occipital lobe as high intensity. CT and MR imaging seemed to indicate metastatic brain tumors, although cortical atrophy and ventricular dilation were recognized. Left parietal craniotomy was performed under stereotactic targeting to obtain a definitive diagnosis. During manipulation at the center of the targeted lesion, a white, tape-like body was found and recognized to be a live worm. Serological testing revealed strong immunopositivity against spirometra mansoni. The infection route in the present case was probably through eating raw chicken meat. Cerebral sparganosis is extremely rare but should be considered in the differential diagnosis of metastatic brain tumors, especially in endemic areas. ( info) |