Cerebrovascular Complications of NeurocysticercosisClinical and Neuroimaging Spectrum
Carlos Cantú, MD;
Fernando Barinagarrementeria, MD
Arch Neurol. 1996;53(3):233-239.
Abstract
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Objective
To describe the clinical and neuroimaging spectrum of cerebral Cysticercus arteritis to clarify the mechanisms of a stroke that is associated with neurocysticercosis.
Design
Case series.
Setting
Tertiary care center.
Patients
Sixty-five patients with strokes that were associated with neurocysticercosis. Based on the extension of cysticercosis, the study group was divided into patients with focal or diffuse cysticercal disease. Patients with focal affection were subdivided into those with small- and large-vessel angiitis.
Measures
For each group, stroke syndromes, mode of onset, associated neurologic syndromes, neuroimaging features of cysticercosis and cerebral infarcts, angiographic and cerebrospinal fluid findings, and outcome were analyzed.
Results
Thirty-five patients had focal cysticercosis (13 with small- and 22 with large-vessel angiitis), and 30 had diffuse disease with either small- or large-vessel involvement. A high frequency of subarachnoidal cysts was found, neighboring the ischemic area. Patients with focal cysticercosis had a vascular onset in 80% compared with 20% in those with diffuse cysticercosis (P<.001). Distinctive findings in diffuse cysticercosis were hydrocephalus (80%), multiple cerebral infarcts (64%), and mental disorders (43%) (P<.001). There was a close parallelism between the type of cysticercosis and the degree of cerebrospinal fluid inflammatory changes, reflecting in the outcome. Death or incapacitating sequelae were associated with diffuse cysticercosis, and total recovery was common in patients with focal disease and small-vessel angiitis, whereas intermediate morbimortality occurred with focal cysticercosis and large-vessel vasculitis.
Conclusion
Based on the distribution of cysticercal disease and the severity of concomitant chronic arachnoiditis, it is possible to identify a wide spectrum of cerebrovascular involvement caused by neurocysticercosis.
Author Affiliations
From the Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
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