Diffusion‐weighted and conventional MR imaging in neurotrichinosis

Abstract

Central nervous system involvement in trichinosis is not rare. Brain lesions in trichinosis have been defined on computed tomography and magnetic resonance imaging (MRI) as multifocal small lesions located in the cerebral cortex and white matter. We present a case of trichinosis with multifocal lesions of the brain detected by MRI and diffusion weighted MRI. Evolutions of these lesions from acute through chronic stages on follow up studies are also presented. This is the first report describing sequential MRI findings and diffusion weighted imaging appearance of brain lesions in trichinosis. Sequential evaluation of conventional and diffusion MR data allowed us to conclude that multifocal lesions in the brain were related to multiple infarctions rather than true inflammatory infiltration of the brain parenchyma.

A Probable Case of Human Neurotrichinellosis in the United States

“…9 Small lesions in the cerebral cortex and white matter can be identified using CT or MRI scans in severe cases. [10][11][12] However, most reports of neurotrichinellosis describe cytobiochemically normal CSF, [13][14][15] as did the case in our report. As such, neurologic manifestations are protean, making the diagnosis enigmatic.…”

Border zone brain lesions due to neurotrichinosis

“…We presented a case with eosinophilia, focal neurological signs and multiple bilateral brain lesions, distributed mainly in the border zones, at the junction between two main arterial territories. This MRI appearance was reported in patients with bilateral border zone infarcts (due to microembolism or severe bilateral carotid stenosis) and hypereosinophilia which can be due to idiopathic hypereosinophilic syndrome or a brain infection (trichinosis, filariasis or schistostomiasis) (Mangla et al, 2011;Gelal et al, 2005).…”

“…Several hypotheses have been proposed for the mechanisms underlying the lesions in neurotrichinosis: obstruction of vessels by larvae and inflammatory cells, toxic or immunoallergic vasculitis with secondary thrombosis and border zone infarcts due to hypereosinophilia (Mangla et al, 2011;Gelal et al, 2005;Gay et al, 1982).…”

Neurotrichinosis in a Pediatric Patient

“…2,[7][8][9] As observed in our patient, treatment with corticosteroids rapidly improves myositis and vasculitis-related symptoms and prevents complications. Steroids should always be administered in combination with antihelmintics such as albendazole.…”