Cisticercose medular relato de dois casos, revisão da literatura e comentários sobre a patogenia

Abstract

A case of spinal intramedullary cysticercosis in a 13-year-old Brazilian female and a case of spinal leptomeningeal infestation by cysticercosis in a 51 year-old Brazilian female are presented. A review of 95 published cases of medullar cysticercosis since 1856 shows the incidence of this condition. Extramedullary forms are explained by the downward migration of larvae from the cerebral to the spinal subarachnoid space and most larvae are expected to be stopped in the upper portions of the spinal canal due to peculiarities of the anatomy of the spinal cord.

Spinal cord cysticercosis: neurosurgical aspects

“…6,8,9,13,20,26,33,36,37 Intradural spinal cysticercosis can be subdivided in leptomeningeal (subarachnoid) or intramedullary forms (parenchymal), the former being the most prevalent type of spinal parasitic infestation. In contrast to CNS lesions caused by the parasite Schistosoma mansoni, 41 in which the spinal cord is the principal site of damage, intramedullary involvement in cysticercosis is seldom observed, accounting for fewer than 20% of the intradural spinal cases.…”

“…33 Epidural cysts are rare. 26 In addition to other stigmata of cerebral cysticercosis, in patients with the spinal form clinical and radiological features may be similar to intra-or extramedullary neoplastic mass lesions. Flaccid or spastic paresis, sensory deficits, sphincter disorders, radiating pain, and pyramidal signs are the most commonly observed clinical manifestations of spinal cysticercosis.…”

Thoracic Intramedullary Cysticercosis. Two Case Reports.

“…[1][2][3][4][5][6][9][10][11][12][13][14]16,18,19,24,25,28) An analysis of 753 cases of neurocysticercosis found the incidence of spinal intramedullary cysticercosis to be 0.77%. 26) About 50% of patients harbored the parasite in other sites, such as the brain (30%) and muscles (25%).…”

“…Intramedullary involvement is uncommon, 3,22) with only 45 reported cases since 1881. [1][2][3]5,7,[9][10][11][12][13][14][15][16][17][18][19][20]23,25,28) We report two cases of spinal intramedullary cysticercosis, and analyze the indications for surgical treatment.…”

Brainstem cysticercose simulating cystic tumor lesion: a case report

“…echinococcosis), CNS neoplasms (astrocytomas, hemangioblastomas, and less likely glioblastoma multiforme), tuberculosis, fungal infections, and benign cystic lesions (epidermoid cyst, simple cyst). Gallani et al 4 reported a 13 year-old girl with an intraspinal cystic lesion at T11-T12 level, without evidence of other cysticercotic lesions in the CNS and with negative immunological findings in the CSF. The diagnosis was also made only after surgical exéresis of the lesion.…”