Doença cerebrovascular e neurocisticercose

Abstract

RESUMO -Apresentamos três casos de arterite do sistema nervoso central associada a neurocisticercose. No primeiro caso, relatamos a ocorrência de arterite bilateral das artérias cerebrais médias em um paciente de 36 anos, com quadro de hemiparesia direita e afasia. A ressonância nuclear do encéfalo evidenciou cisto racemoso parietal direito e infarto temporal esquerdo. O estudo angiográfico mostrou oclusão total da artéria cerebral média esquerda e oclusão subtotal da artéria cerebral média direita. No segundo caso demonstramos a ocorrência de vasculite de pequenos vasos em um paciente de 42 anos, com quadro de cefaléia, crises convulsivas, afasia e déficit motor. A tomografia de crânio revelou calcificações intraparenquimatosas e área isquêmica temporal esquerda. O estudo angiográfico cerebral revelou-se normal. O terceiro caso trata de uma paciente de 53 anos de idade com história pregressa de seis episódios de acidente vascular cerebral e quadro atual de distúrbio do comportamento e convulsões. A tomografia e ressonância nuclear magnética de crânio revelaram múltiplos infartos lacunares e cistos cisternais. A angiografia cerebral mostrou arterite de vasos intracranianos tanto do sistema carotídeo como vértebro-basilar. Nos três casos o estudo quimiocitológico do líquor mostrou pleocitose linfomonocitária e reação imunológica (ELISA) para cisticercose positiva.PALAVRAS-CHAVE: neurocisticercose, acidente vascular cerebral, arterite cerebral. Cerebrovascular disease and neurocysticercosisABSTRACT -We report three cases of stroke secondary to neurocysticercosis. The first one is a 36 years old man with bilateral middle cerebral artery occlusions who had presented acute right hemiparesia and aphasia. MRI demonstrated several enhancing subarachnoid cysts surrounding the occluded vessels, a right parietal racemose cyst and a left temporal large infarction area. Angiographic study showed total occlusion of left middle cerebral artery and a subtotal occlusion of right middle cerebral artery. The second one is a 42 years old man with vasculitis of small cortical vessels who presented with headache, seizures and focal neurological deficit. CT scan demonstrated several calcifications and a left temporal infarction area. Cerebral angiographic study was normal. The third case was a woman, 53 years old, with a past history of six stroke events and an actual behavior disturbance and seizures. MRI demonstrated several cortical and subcortical infarction areas and cisternal cysts. Angiographic study showed diffuse arteritis of basilar and carotid arterial system. In all three cases CS. study showed linfomonocitic pleocytosis and positive ELISA for cysticercosis.KEY WORDS: neurocysticercosis, stroke, arteritis. Dra. Maria Sheila Guimarães Rocha -Rua Gandavo 100 / 111 -04023-000 São Paulo SP Brasil. E-mail: msrocha@uol.com.br A cisticercose é a doença parasitária que mais frequentemente atinge o sistema nervoso central (SNC), sendo endêmica em muitos países subdesenvolvidos, especialmente na América Latina, Central e na Áfri-ca ...

Neurocysticercosis-related mortality in Brazil, 2000–2011: Epidemiology of a neglected neurologic cause of death

“…HIV/AIDS can aggravate the condition of NCC patients (Delobel et al, 2004;Santo, 2007), but further studies are necessary to establish the effect of NCC-HIV co-infection in aggravating or deterioration of both diseases (Anand et al, 2014). Stroke, a relatively common but neglected complication of NCC, is caused by inflammatory occlusion of the arteries of the brain (Rocha et al, 2001;Santo, 2007).…”

Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review

“…Small- or large-vessel involvement may also cause infarcts in subarachnoid neurocysticercosises. 36 Three cases of stroke secondary to neurocysticercosis were reported by Rocha et al 37 : one patient had stroke secondary to subarachnoid cysts, causing bilateral middle cerebral artery occlusion that was angiographically proven; the second patient had arteritis of the basilar and carotid arterial systems secondary to cisternal cysts; and the third patient had vasculitis of the small cortical vessels.…”

Cysticercosis-related mortality in the State of São Paulo, Brazil, 1985-2004: a study using multiple causes of death

“…In this study, cerebrovascular diseases were an associated cause in 7.69% (87/1,131) of deaths with cysticercosis as the underlying cause, and were identified as the underlying cause in 16.86% of deaths (74/439) in which cysticercosis was an associated cause. The international literature advises detailed examination and caution in accepting a causal relationship between neurocysticercosis and cerebrovascular disease 26 . This is reflected in the decision tables for automatic processing, in which this causal relationship, which had not existed previously 16 , was only recently included 17 .…”