Neuroradiology

, Volume 34, Issue 1, pp 1–8 | Cite as

Cerebral sparganosis: analysis of 34 cases with emphasis on CT features

  • K. H. Chang
  • J. G. Chi
  • S. Y. Cho
  • M. H. Han
  • D. H. Han
  • M. C. Han
Diagnostic Neuroradiology

Summary

Cerebral sparganosis is a rare parasitic CNS disease, producing chronic active granulomatous inflammation. We retrospectively reviewed the clinical data, CT scans and histopathologic specimens in 34 patients with cerebral sparganosis. The majority of the patients (89%) were rural inhabitants; 75% had a history of ingestion of frogs and/or snakes. The major presenting symptoms were seizure (84%), hemiparesis (59%) and headache (56%) of chronic course. On CT scans, the disease most frequently involved the cerebral hemispheres, particularly frontoparietal lobes, with occasional extension to the external and internal capsules and basal ganglia. The cerebellum was rarely involved. Bilateral involvement was seen in 26%. The main CT findings consisted of white matter hypodensity with adjacent ventricular dilatation (88%), irregular or nodular enhancing lesion (88%), and small punctate calcifications (76%). In combination, the CT triad above appears to be specific for this disease, and was noted in 62% of cases. Of 16 follow-up CT scans, 5 (38%) showed a change in the location of the enhancing nodule. With a single CT scan, it does not appear to be possible to determine whether the worm is alive or dead, information important for deciding whether to intervene surgically. Change in the location of the enhancing nodule and/or worsening of the other CT findings on sequential CT scans would suggest that the worm is alive and that the patient is a candidate for surgery.

Key words

Brain Infection Computed tomography Parasites Inflammation Sparganosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Cho SY (1983) Diphyllobothriasis and sparganosis. In: Weatherall DJ, Ledingham JGG, Warrell DA (eds) Oxford textbook of medicine. Oxford University Press, Oxford, pp 5448–5449Google Scholar
  2. 2.
    Cho SY, Bae JH, Seo BS, Lee SH (1975) Some aspects of human sparganosis in Korea. Korean J Parasitol 13:60–77Google Scholar
  3. 3.
    Muller JF, Hart EP, Walsh WP (1963) Human sparganosis in the United States. J Parasitol 49:294–296Google Scholar
  4. 4.
    Mineura K, Mori T (1980) Sparganosis of the brain: case report. J Neurosurg 52:588–590Google Scholar
  5. 5.
    Anders K, Foley K, Stern E, Brown WJ (1984) Intracranial sparganosis: an uncommon infection—case report. J Neurosurg 60:1282–1286Google Scholar
  6. 6.
    Fan KJ, Pezeshkpour GH (1986) Cerebral sparganosis. Neurology 36:1249–1251Google Scholar
  7. 7.
    Anegawa S, Hayashi T, Ozuru K, Kuramoto S, Nishimura K, Shimizu T, Hirata M (1989) Sparganosis of the brain. Case report. J Neurosurg 71:287–289Google Scholar
  8. 8.
    Yamashita K, Akimura T, Kawano K, Wakuta Y, Aoki H, Gondou T (1990) Cerebral sparganosis mansoni. Report of two cases. Surg Neurol 33:28–34Google Scholar
  9. 9.
    Chang KH, Cho SY, Chi JG, Kim WS, Han MC, Kim CW, Myung H, Choi KS (1987) Cerebral sparganosis: CT characteristics. Radiology 165:505–510Google Scholar
  10. 10.
    Kim H, Kim SI, Cho SY (1984) Serological diagnosis of human sparganosis by means of micro-ELISA. Korean J Parasitol 22:222–228Google Scholar
  11. 11.
    Chi JG, Chi HS, Lee SH (1980) Histopathologic study on human sparganosis. Korean J Parasitol 18:15–23Google Scholar
  12. 12.
    Fukase T, Matsuda Y, Akihama S, Itagaki H (1984) Some hydrolyzing enzymes, especially arginine amidase, in plerocercoids of Spirometra erinacei (Cestoda; Diphyllobothriidae). Jpn J Parasitol 33:283–290Google Scholar
  13. 13.
    Fukase T, Matsuda Y, Akihama S, Itagaki H (1985) Purification and some properties of cysteine protease of Spirometra erinacei plerocercoid (Cestoda; Diphyllobothriidae). Jpn J Parasitol 34:351–360Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • K. H. Chang
    • 1
    • 5
  • J. G. Chi
    • 2
  • S. Y. Cho
    • 4
  • M. H. Han
    • 1
  • D. H. Han
    • 3
  • M. C. Han
    • 1
  1. 1.Department of RadiologySeoul National University College of MedicineSeoulKorea
  2. 2.Department of PathologySeoul National University College of MedicineSeoulKorea
  3. 3.Department of NeurosurgerySeoul National University College of MedicineSeoulKorea
  4. 4.Department of ParasitologyChung-ang University College of MedicineSeoulKorea
  5. 5.Department of Diagnostic RadiologySeoul National University HospitalSeoulKorea

Personalised recommendations