脑裂头蚴病一例并文献复习  

Cerebral sparganosis:A case report and review of literature

作　　者：董秦雯[1] 莫亚雄[2] 卢德宏[3] 张海玲[1] 刘建国[1] 姚生[1] 戚晓昆[1] 

机构地区：[1]海军总医院神经内科,100048 [2]昆明医学院第一附属医院儿科,650000 [3]首都医科大学宣武医院病理科,100053

出　　处：《中国神经免疫学和神经病学杂志》2014年第2期94-97,共4页Chinese Journal of Neuroimmunology and Neurology

摘　　要：目的探讨脑裂头蚴感染的临床及影像学特点,提高对该病的认识和诊疗思路。方法结合1例表现为反复头痛伴恶心呕吐的脑裂头蚴感染患者的临床资料及曲折诊疗过程,并复习相关文献,探讨本病的临床、影像及病理学特点。结果患儿临床表现以头痛为主,影像学上可见右侧颞顶枕叶多发异常信号影,增强可见"隧道样、绳结样"强化,血清裂头蚴抗体阳性,脑立体定向活检术后脑组织病理可见典型的肉芽肿性改变及石灰样小体等寄生虫感染的证据。结论脑裂头蚴病北方较少见,临床上容易误诊。MRI增强扫描呈"隧道样、绳结样"改变有特征性,血清免疫学检查裂头蚴抗体阳性特异性高,脑立体定向活检术发现活的虫体或残骸可辅助诊断。Objective To investigate the clinical and imaging characteristics of cerebral sparganosis so as to improve the diagnosis thinking. Methods Combined the clinical materials with the reviewed documents, to investigate the clinical, imaging and pathological characteristics. Results The main clinical manifestation was headache. Image findings revealed multiple focus on the right cerebral hemisphere. MRI showed tunnel sign and knot sign enhancement. Positive serum reaction. Granulomatous inflammatory reaction and calcareous corpuscles could be seen in pathology after stereotactic operations. Conclusions Cerebral sparganosis is rare in Northern China and easy to be misdiagnosed. Cerebral sparganosis has characteristic imaging features （tunnel like or knot like enhancement after contrast injection）, serum immunological examination （positive for pleroceroid antibodies） shows favorable specificity. Stereotactic operations find the worm or remains can help diagnose.

关 键 词：脑裂头蚴病 病理学 磁共振成像 脑寄生虫病 

分 类 号：R532.31[医药卫生—内科学]