Hemorrhagic Cerebrovascular Events and Neurocysticercosis: A Case Report and Review of the Literature

Viola, George M.; White, A. Clinton; Serpa, José A.

doi:10.4269/ajtmh.2011.10-0429

Cited by 23 publications

(17 citation statements)

References 12 publications

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“…Seizures can arise, but less frequently. Subarachnoid cysts can generate an inflammatory response that can then lead to chronic arachnoiditis, which then may become complicated by hydrocephalus, meningitis, stroke and vasculitis …”

Section: Discussionmentioning

confidence: 99%

A lumbar canal cystic mass lesion in a man with a history of chronic lower back pain

Torous

Darras

2015

Neuropathology

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A 40 year old Indian man with a history of chronic lower back pain presented with an acute worsening of his back pain, bilateral lower extremity pain and bladder difficulty.The patient's back pain had initially begun approximately 2 years prior. He treated himself intermittently with ibuprofen, with good relief, and the pain gradually resolved. Ayear and a half later, the patient began to experience increasingly worse back pain, as well as numbness of his left leg. He went to his primary care physician and a diagnosis of piriformis syndrome was rendered. He was given steroid and botulinum toxin injections with some relief. During this time, the patient was traveling to India to visit an ailing family member. He had an acute worsening of symptoms prior to presentation at our facility, and was prescribed a muscle relaxant, physical therapy and hydrocodone by his primary care physician.However, the patient began to experience a complete loss of sensation in his left foot, subjective bilateral lower extremity weakness (left greater than right), and urinary hesitancy with a sensation of fullness and an inability to completely void his bladder. This prompted him to seek emergent medical attention, at which time an MRI was performed and imaging demonstrated a heterogeneously enhancing L4-S1 cystic lesion that was compressing the nerve roots (Fig. 1). The differential diagnosis included a number of possibilities, although there was the most concern for a malignancy of the spine. Imaging demonstrated no additional lesions or masses, including of the remainder of the spine as well as the brain. The patient denied any other symptoms, including urinary/bowel incontinence, saddle anesthesia, fevers, chills or changes in vision.Due to the patient's progressive symptoms, with compressive symptoms from the mass, and the need for diagnosis, surgery was indicated and the patient was taken for surgical intervention the next day. A laminectomy was performed at L4, L5 and S1. The dura was incised, tacked away, and the arachnoid space was entered to reveal a 2.5 cm cystic mass with tissue herniation through the opening. Fenestration of the cyst was then performed, and the tissue was sent to pathology for microscopic examination. PATHOLOGICAL FINDINGSHistologic examination of the specimen showed a fibrous pseudo-capsule that surrounded a retracted and collapsed cyst. The fibrous pseudo-capsule was composed of collagenous tissue with minimal inflammatory cells, including lymphocytes and eosinophils, with a layer of histiocytes adjacent to the cyst. The cyst itself was comprised of an outer layer of homogenous eosinophlic material, consistent with tegument, with a row of viable cells with clear cytoplasm and small round nuclei (tegumental cells), and loose edematous stroma with numerous calcospherites ( Fig. 2A, 2B). The histologic findings were consistent with larval forms and cysticercosis.The patient was doing well in the immediate postoperative period, although his postoperative course was complicated by a pulmonary embolus formation...

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Section: Discussionmentioning

confidence: 99%

A lumbar canal cystic mass lesion in a man with a history of chronic lower back pain

Torous

Darras

2015

Neuropathology

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“…Almost all clinical presentations of stroke can be seen in epileptic patients having SNCC [27,41,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. Despite the increasing number of reports on haemorrhagic stroke to the medical literature [19, 20, 23, 24, 26, 27, 29-31, 37-41, 47-62], the prevalence of stroke secondary to NCC remains higher in IS secondary to infectious vasculitis.…”

Section: Strokementioning

confidence: 99%

“…However, large infarcts related to the occlusion of the middle cerebral artery or even the internal carotid artery have also been reported [50]. Viola et al [57] reported a patient who presented with relapsed subarachnoid haemorrhage possibly linked to NCC. In addition, they performed a literature review of all of the reported cases of aneurysmal and non-aneurysmal haemorrhagic cerebrovascular events associated with NCC until year 2011 and identified 11 such cases.…”

Section: Strokementioning

confidence: 99%

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Subarachnoid Cysticercosis and Ischaemic Stroke in Epileptic Patients

Foyaca-Sibat¹,

Valdés²

2018

Seizures

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Whether subarachnoid neurocysticercosis (SNCC) induces ischaemic stroke (IS) in epileptic patients is not yet confirmed because only short-case series and anecdotal case reports have been published, and no observational studies exist in the literature to date. Our main goals are: to estimate the prevalence of ischaemic stroke in epileptic patients presenting with SNCC and stroke frequency among HIV-positive patients in three subgroups; to determine if the odds of ischaemic stroke are elevated in SNCCepileptic patients compared to epileptic patients with intraparenchymal NCC (INCC); to determine whether the risk for stroke is elevated in HIV-seropositive patients presenting with SNCC or INCC and epilepsy; and to evaluate if and when the potential interaction varies by location of NCC in the brain (intraparenchymal or subarachnoid). Eligible epileptic patients' seropositive status was recorded, and cross-associations for the independent variables (NCC status and HIV status) and outcome variables (ischaemic stroke event) were performed. Compared to the reference group, the odds of IS in PLWNCC were 2.0 and 2.6 times greater in patients with SNCC and INCC, respectively. The frequency of IS was greater in HIV-positive patients in all three groups, but the risk was especially pronounced when seropositive epileptic patients were both NCC groups when compared with the reference group. Subarachnoid NCC increased the risk of IS three time more.

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“…Hemorrhagic stroke can also occur in NCC . The above‐described inflammatory damage to the endothelium leads to oedema, thrombosis, weakening of the arterial wall and subsequent formation of fusiform pseudoaneurysms that may eventually break .…”

Section: Clinical Manifestations Of Nccmentioning

confidence: 99%

Pathogenesis ofTaenia soliumtaeniasis and cysticercosis

Gonzáles

Rivera

Garcı́a

2016

Parasite Immunology

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Taenia solium infections (taeniasis/cysticercosis) are a major scourge to most developing countries. Neurocysticercosis, the infection of the human nervous system by the cystic larvae of this parasite, has a protean array of clinical manifestations varying from entirely asymptomatic infections to aggressive, lethal courses. The diversity of clinical manifestations reflects a series of contributing factors which include the number, size and location of the invading parasites, and particularly the inflammatory response of the host. This manuscript reviews the different presentations of T. solium infections in the human host with a focus on the mechanisms or processes responsible for their clinical expression.

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Hemorrhagic Cerebrovascular Events and Neurocysticercosis: A Case Report and Review of the Literature

Cited by 23 publications

References 12 publications

A lumbar canal cystic mass lesion in a man with a history of chronic lower back pain

A lumbar canal cystic mass lesion in a man with a history of chronic lower back pain

Subarachnoid Cysticercosis and Ischaemic Stroke in Epileptic Patients

Pathogenesis ofTaenia soliumtaeniasis and cysticercosis

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