Diagnosis and stereotactic aspiration treatment of cerebral sparganosis: summary of 11 cases

Abstract

The authors concluded that an effective preoperative diagnosis of cerebral sparganosis can be made by detailed inquiry into the possible infection history and disease symptoms as well as careful scrutiny of characteristic radiological features and immunological testing results. In stereotactic operations performed to remove the larva, priority should be given to image-guided stereotactic aspiration given that it causes the smallest wounds. In cases in which stereotactic aspiration fails, stereotactic microsurgery should be performed to remove the larva. The surgeon must carefully avoid breaking the larva and leaving behind any larva residue during surgery.

High-dose praziquantel therapy for cerebral sparganosis

“…The treatment of choice for cerebral sparganosis is surgical removal because treatment with antihelmintics, including praziquantel, has been described as not effective [1][2][3]. In our patient the clinical improvement, and the normalisation of brain imaging and of anti-sparganum antibody levels suggest that the parasite was eradicated by high dose praziquantel therapy.…”

“…The patient was suspected to have neurocysticercosis and was treated with albendazole Surgical removal of the parasite is the treatment of choice as standard antihelmintic therapy is considered ineffective in sparganosis [1][2][3]. The repeated MRI indicated that the lesion had been wandering again (D and J).…”

Migration: A Notable Feature of Cerebral Sparganosis on Follow-Up MR Imaging

“…7 The postulated route of sparganum infestation to the brain is that first it passes through the alimentary canal to the abdominal cavity; then it penetrates the diaphragm and mediastinum upwards to reach the neck, where it further migrates up through the foramen magnum or jugular foramen; and finally, it reaches the brain. 8 A definite diagnosis of cerebral sparganosis is challenging due to its nonspecific clinical manifestation. Previously, it was often misdiagnosed as a neoplasm, 9 infarct, 10 tuberculoma, 11 or other diseases.…”

“…With the availability of high-resolution CT and MR imaging, the ELISA test for parasitic antibodies, and stereotactic biopsy, more cases of sparganosis are being diagnosed currently. 8,12 Characteristic imaging features like the "tunnel"…”

Esparganosis cerebral. Presentación de un caso pediátrico

“…11 Su incidencia en nuestro medio está relativizada debido a la ausencia de manifestaciones clínicas características y, desde el punto de vista histológico, por la presencia de una respuesta granulomatosa, inespecífica si no se logra visualizar el parásito. En la gran mayoría de los casos el diagnóstico de estas formas cerebrales es posquirúrgico e histopatológico.…”