Intramedullary cysticercosis of the spinal cord: A review of patients evaluated with MRI
Intramedullary cysticercosis of the spinal cord: A review of patients evaluated with MRI
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DOI：
10.1016/j.jns.2013.05.025
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发表时间：
2013-08-15
影响因子：
4.4
通讯作者：
Garcia, Hector H.
中科院分区：
文献类型：
--
作者：
Del Brutto, Oscar H.;Garcia, Hector H.
目的：回顾脊髓髓内囊虫病的MRI诊断的情况下，概述的特点和结果，这种被忽视的形式介绍的neurocysticercosis.Methods：MEDLINE，LILACS，和手动搜索的病例报告或病例系列的髓内囊虫病的MRI评价的患者。摘要数据包括：人口统计学特征、临床表现、神经影像学表现、治疗和随访。平均年龄为36岁，65%为男性。大多数患者（67%）的寄生虫位于胸脊髓。除两名患者外，所有患者均为单一囊肿。最常见的表现形式是亚急性或慢性横贯性脊髓病。在MRI上，所有病变的信号特性与CSF相似，大多数被水肿包围，并有一个“环形”模式的异常增强。16例（37%）可见寄生虫头节。29例患者接受了手术切除病变，14例接受了药物治疗。20例接受药物治疗的患者和13例接受药物治疗的患者的随访数据可用。20例接受药物治疗的患者中有12例（60%）完全康复，其余患者留下后遗症或未改善。与此相反，所有13例药物治疗后，使用杀囊药物加皮质类固醇（11例）或皮质类固醇单独（2例）完全恢复。结论：髓内囊虫病是罕见的。临床和神经影像学表现可能与其他髓内病变相似，但头节的可视化或颅内病变的偶然发现提供了有用的诊断线索。如果怀疑诊断正确，患者接受及时治疗，预后是良性的。(C)2013 Elsevier B.V.保留所有权利。
Objective: Review of cases of intramedullary spinal cord cysticercosis diagnosed with MRI to outline the features and outcome of this overlooked form of presentation of neurocysticercosis.Methods: MEDLINE, LILACS, and manual search of case reports or case series of patients with intramedullary cysticercosis evaluated with MRI. Abstracted data included: demographic profile, clinical manifestations, neuroimaging findings, therapy, and follow-up.Results: Forty-three patients were reviewed. Mean age was 36 years, and 65% were men. Most patients (67%) had parasites located at the thoracic spinal cord. All but two patients had a single cyst. The most common form of presentation was a subacute or chronic transverse myelopathy. On MRI, all lesions had signal properties paralleling that of CSF, and most were surrounded by edema and had a "ring-like" pattern of abnormal enhancement. The scolex of the parasite was visualized in 16 (37%) cases. Twenty-nine patients underwent surgical resection of the lesion, and 14 were medically-treated. Follow-up data was available in 20 surgically-treated and 13 medically-treated patients. Twelve (60%) of the 20 surgically-treated patients recovered completely, and the remaining were left with sequelae or did not improve. In contrast, all the 13 medically-treated patients recovered completely after the use of cysticidal drugs plus corticosteroids (11 cases) or corticosteroids alone (two cases).Conclusions: Intramedullary cysticercosis is rare. Clinical and neuroimaging findings may resemble those of other intramedullary lesions, but the visualization of the scolex or the incidental discovery of intracranial lesions provide helpful diagnostic clues. Prognosis is benign provided the correct diagnosis is suspected and patients receive prompt therapy. (C) 2013 Elsevier B.V. All rights reserved.