1/25. Intramedullary cysticercosis. Case report, literature review and comments on pathogenesis.A 60-year-old woman developed progressive spastic crural paraplegia and global anesthesia and global anesthesia below T10, succumbing to urinary infection and bronchopneumonia 8 months after the onset of symptoms. At necropsy, the spinal cord was completely destroyed by a necrotic intramedullary cysticercus at T8. Six cysticerci were found in the brain. A review of the 17 published cases of intramedullary cysticercosis (including this one) showed this condition to be clinically indistinguishable from spinal cord tumours. The surgical prognosis was fair in 8 of 11 operated patients. The role of hematogenous and ventriculo-ependymal pathways in the pathogenesis of intramedullary cysticercosis was examined. The topographical distribution of intramedullary cysticerci (5 cervical, 12 thoracic, 2 lumbar, none sacral) was found to be statistically proportional to the blood flow to each of these regions; this favours the hematogenous route of infestation. The low spinal cord blood flow (100 times less than that to the brain), the type of vascularization of the cord (low calibre vessels under low pressure) and peculiarities of the cord tissue (such as its harder consistency) are all thought to be contributory factors accounting for the scarcity of intramedullary cysticerci. No evidence for an ependymal route of spread could be adduced.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/25. Positive reaction for cysticercosis and multicentric anaplastic oligoastrocytoma.INTRODUCTION: An unusual case of positive immunological testing for cysticercosis in the cystic fluid obtained from an anaplastic oligoastrocytoma is presented. CASE REPORT: A 15-year-old boy was admitted with multiple brain lesions. The biggest was a cyst with a mural node and neurocysticercosis was suspected. In order to relieve intracranial pressure, the cyst was punctured and the immunological testing for cysticercosis was positive, reinforcing the clinical suspicion and leading to a clinical trial with albendazole and steroids. As the patient deteriorated the cystic lesion was removed and the diagnosis of anaplastic oligoastrocytoma was established. A second lesion was eventually approached and the histopathological diagnosis of both specimens concurred. DISCUSSION: Although some authors believe that chronic inflammatory changes following neurocysticercosis could induce the formation of brain tumors, this association may be a mere coincidence. In our case no clinical evidence of a prior infestation by cysticercus was found. In fact, an exhaustive examination of the specimens did not reveal any areas of inflammatory reaction. We believe that the similarity of the glioma and cysticercosis antigens may be the cause of the positive reactions in the cystic fluid.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/25. neurocysticercosis and nursing implications.neurocysticercosis causes significant neurologic morbidity and mortality in many countries and is increasing in frequency in the united states. The disease should be considered in any patient who has lived in or traveled to an area where it is endemic and who presents clinically with signs of increased intracranial pressure, stroke, seizures, or other neurologic deficits. neurocysticercosis can be a life-threatening disease depending on the size, location, and active or inactive status of the cysts. neurocysticercosis is treatable both medically and surgically according to symptoms. The sooner the correct diagnosis is made, the greater the chances for recovery and prevention of further neurologic deterioration. The nurse who is knowledgeable about the cause and treatment for neurocysticercosis can assist in controlling the incidence of this disease, decreasing complications, and averting needless mortality.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/25. Definition of the role of contemporary surgical management in cisternal and parenchymatous cysticercosis cerebri.With increasing immigration from endemic regions, the incidence of neurocysticercosis in north america is rising. This retrospective study was undertaken to examine the role of surgery in those cases presenting with large cystic parenchymal and cisternal lesions in the current era of anthelminthic agents administered orally. A total of 237 patients presented with newly diagnosed neurocysticercosis to our institution over a recent 5-year period (mean age, 31.2 years). Among those who presented with cystic mass lesions predominantly affecting the brain parenchyma and cisternal spaces, 20 (8.4%; mean age, 40.2 years) with large cystic lesions subsequently underwent surgical intervention, either because of an emergent presentation or because they were refractory to medical management. Clinical presentation included increased intracranial pressure, focal neurological deficit, and seizure. Radiographic imaging (computed tomography and/or magnetic resonance imaging) demonstrated 12 cases with cisternal lesions, 7 with parenchymal lesions, and 1 involving both compartments. Based on imaging guidelines, 30 operative procedures (excluding shunt revisions) were performed (14 craniotomies, 8 cerebrospinal fluid diversions, 7 stereotactic procedures, and 1 burr hole drainage). Fifteen (75%) showed neurological or symptomatic improvement over a median follow-up period of 36.4 months. There were three surgery-related complications and no deaths.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/25. Disseminated cysticercosis. New observations, including CT scan findings and experience with treatment by praziquantel.Although the symptom complex of disseminated cysticercosis has been well recognized for over half a century, it is not clearly included in recent disease classifications. Three such patients are described whose main features were uncontrolled seizures, progressive dementia, behaviour disorder, muscular pseudohypertrophy, and a relative paucity of localizing neurological signs or signs of raised intracranial pressure. Radiographic calcification in muscles was not seen. A CT scan of the brain showed numerous small discrete lesions. Their attenuation density values were appreciably less than that of calcium and they enhanced slightly with contrast. Magnification revealed that these were scolices within cysticerci. There was no enhancement of the cyst wall and no pericystic oedema. CT scan of muscles showed similar cysticerci producing a 'honeycomb' appearance. This is the first CT demonstration of widely disseminated living cysticerci in brain and muscles. It was confirmed histologically. In the absence of palpable cysticerci, the clinical diagnosis can be missed, although no other disease in its full form presents in this manner. The symptoms are mainly caused by the space-occupying effect of the large number of cysticerci rather than by adjacent tissue swelling such as is seen in the presence of dying parasites. praziquantel was ineffective and hazardous, causing some known and some previously unreported responses and reactions. All 3 patients died.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/25. Childhood central nervous system cysticercosis in australia.Cysticercosis of the central nervous system is seen infrequently in australia. Most cases occur in adults, but two imported cases of neurocysticercosis in children are described. A 10-year-old Anglo-Indian girl presented with aseptic meningitis, raised intracranial pressure and a block to the flow of cerebrospinal fluid in the lumbar region. laminectomy showed two cysticerci in the spinal subdural space. A three-year-old boy from zimbabwe suffered a focal seizure. A granuloma that contained a degenerate cysticercus was found in the left parietal cortex. Serological examination of blood for cysticercosis was performed only in the second case and gave negative results. Examination of stools in both children gave negative results for the presence of parasites, cysts and ova.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/25. Intraparenchymal cerebral cysticercosis in children: a benign prognosis.This paper reports 26 consecutive cases of cerebral cysticercosis in children, 21 presenting with intraparenchymal mass lesions, two with encephalitic disease, and three with intraventricular (racemous) cysticercosis. The intraparenchymal and encephalitic forms of the disease were benign. Regression of the lesions occurred within four months of diagnosis in all children treated conservatively with antiepileptic drugs, but no antiparasitic drugs. Major morbidity was limited to those patients who were subjected to operative intervention. Intraventricular disease was most malignant; all three patients manifested acute, severely increased intracranial pressure, all required immediate surgical decompression, and one patient died. The apparent overall benign course of intraparenchymal cerebral cysticercosis in children appears not to warrant antiparasitic drug therapy.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/25. Cerebral cysticercosis.Five patients with cerebral cysticercosis, two within the year preceding the date of this article, were seen at the new york Neurological Institute. The patients presented with mental changes, seizures, and symptoms of increased intracranial pressure, and had a history of having immigrated from an area endemic for cysticercosis. They were found to have parenchymal or intraventricular cysticercosis cysts. The interval from immigration to onset of symptoms was as long as 3 years. Plain radiograms of the skull and soft tissues, ventriculograms, and especially the CT scan, as well as the CSF examination, were useful in making the diagnosis. Surgical removal of an intraventricular cyst was curative in two patients and seizures were controlled with anticonvulsants in the other three.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/25. Cerebral cysticercosis in children in south africa.Sixty-one children with cerebral cysticercosis are presented. The commonest clinical manifestation was epilepsy with or without focal signs in 43% of children, followed by the syndrome of raised intracranial pressure in 34% and meningoencephalitis in 13%. The CT scan was positive in 93% of cases and the HAI test in 86% of children so examined. Both were positive in 80%. skull X-ray revealed evidence of calcification and/or raised intracranial pressure in 60%. Two children died, one each with subacute sclerosing panencephalitis and tuberculous meningitis. Of those who improved on discharge, 43% had epilepsy and 32% neurological deficit of an obvious nature. The parasitology, pathogenesis, pathology and diagnosis of cerebral cysticercosis are briefly reviewed. Present therapy and the suggested use of a specific anti-cysticeral drug are discussed. Case histories are presented to draw attention to the variability of the clinical picture and the particular importance of recognising the acute parenchymatous form of the disease in children which may present with critically elevated intracranial pressure.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
10/25. Cerebral cysticercosis.Twenty cases of cysticerosis involving the central nervous system were seen during a 6-year period. Twelve patients presented with symptom and signs of raised intracranial pressure, 6 with seizures and 1 each with subacute meningitis and psychosis. The diagnosis of cerebral cysticercosis was established by brain biopsy in 8 patients, at autopsy in 3, and by biopsy of a subcutaneous nodule in 7. It was presumed on the basis of typical intracranial calcification in 1 case and soft tissue calcification in another. The protean clinical manifestations of this condition and the diagnostic difficulties it raises are discussed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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