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9 - STROKE AND VASCULITIS IN PATIENTS WITH CYSTICERCOSIS

from PART I: - INFECTIOUS AND INFLAMMATORY CONDITIONS

Published online by Cambridge University Press:  06 January 2010

Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Julien Bogousslavsky
Affiliation:
Valmont Clinique, Glion, Switzerland
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Summary

Cysticercosis is caused by infection with the larval stage ofTaenia solium, the pork tapeworm. A brief description of the many changes that cysticerci induce in the central nervous system (CNS) is necessary to understand the pathogenesis of neurocysticercosis (NCC) related stroke. Lacunar infarctions occur as the result of inflammatory occlusion of small penetrating branches of the middle cerebral artery (MCA). Another cerebrovascular complication of NCC is hemorrhagic stroke. Stroke is common among patients with subarachnoid NCC, but it is seldom observed in other forms of the disease. CT and MRI show the infarction as well as the characteristic findings of subarachnoid NCC, including abnormal enhancement of leptomeninges, hydrocephalus, and cystic lesions located at the sylvian fissure or basal cisterns. Introduction of cysticidal drugs (albendazole and praziquantel) have greatly improved the prognosis of NCC by destroying intracranial cysts and improving the neurological manifestations in most patients with parenchymal NCC.
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Publisher: Cambridge University Press
Print publication year: 2008

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