Journal List > J Korean Radiol Soc > v.15(2) > 1137592

Kim, Chang, Kang, Han, Choi, and Sim: Radiologic findings of cysticercosis involving central nervous system

Abstract

The diagnosis of cysticercosis of central nervous system should be considered in patients wtih seizures, symptoms of increased I.C.P. or focal neurologic sign, with a history of having lived in an endemic area, particularly in Korea. Since these cysts usually continue to grow and medical treatment is very limited it isimportant identify them and consider the feasibility of removing them surgically. 20 cases of surgically provencysticercosis of the central nervous system were radiologically analyzed, experienced at Seoul National Univiersity Hospital. Radiologic studies included plain radiography of the skull, angiography, ventriculography, and CT scanning which is especially effective in diagnosis of diffuse parenchymal cysticercosis. The results areas follows; 1. Male to female ratio is 11:9 and mean age of the patients is 36 years. The cardinal symptoms andsigns are seizures (50%), symptoms of increased I.C.P.(45%) mental change (20%) and focal neurologic sign(20%). 2.The distribution of cysts are cerebral parenchymal (40%), 4th ventricle (30%), 3rd ventricle (10%), leptomeningeal(30%), and intraspinal form (15%). 3. Simple skull film shows sign of increased I.C.P.(25%) but no case of calcification. In carotid angiography hydrocephalus is detected in all 13 cases. Displacement of adjacenet vesslesis seen in 2 cases of parenchymal form. Ventriculography shows dilated ventricles with free floating avoid filling defect in intraventricular form and 4th ventricle outlet obstruction in leptomeningeal form. 4. Of spinalcysticercosis 2 cases are leptomeningeal and 1 case intramedullary form. 2 cases are found in cervical portion and1 case in cauda equina region. Myelography reveals filling defect not distinguishable from other tumorous condition. 5. On CT scanning variable degree of hydrocephalus is seen including round symmetric expansion ofcyst-containing ventricle. In leptomeningeal form enlarged cisterna magna is demonstrated without any enhancementor outline of cystic wall. In parenchymal form there are multiple round areas of low density with slightring-enhancement in post contrast study. 6. CT is very helpful to determine surgical indication, to evaluate the function of VA shunt and to detecet the appearance of new cysts in post-operative patients.

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