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KMID : 0359819770060020613
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Journal of Korean Neurosurgical Society
1977 Volume.6 No. 2 p.613 ~ p.623
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Cerebral Paragonimiasis
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이상호/Lee, Sang Ho
심성보/전용문/옥영철/이규웅/Shim, Sung Bo/Jun, Yong Moon/Ok, Yung Chul/Lee, Kyu Woong
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Abstract
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Pagonimus Westmani, occuring as an important human infestation of the lung, is widely distributed in the Far East; Korea, Japan, Chinaa and the Philippines. Since Otani found the parasites for the first time in the human brain in 1887, it has been established that cerebral infestation occurs with the highest frequency among extrapulmonary involvement.
In 0. 8 to 25 percent of patients infested with the lung flukes cerebral paragonimiasis may be developed. The larvae may produce arachnoiditis, abscess, fibrous cystic lesions and granulomas in the brain.
Based on a review of the literatures and upon the 7 cases of cerebral paragonimiasis which have been observed by the authors at the National Medical Center, Seoul, Korea, the following points are stressed.
1) Males had a significantly higher prevalence than females. Cerebral paragonimiasis was most commonly found in young adults (16 to 25yrs).
2) Clinically the patients with cerebral involvement were characterized by Jacksonian type of epilepsy, headache and visual disturbance. Mental deterioration, hemiplegia, hemihypes thesia, homonymous hemianopsia and optic atrophy were the five major signs.
3) The patients having symptoms for less than 6 months developed mild leukocy tosis in many cases. All the cases of cerebral paragonimiasis revealed positive reaction in the intradermal tests with purified antigens of P. Westermani.
4) On skull films multiple round or oval ;cystic calcification was diagnostic value for cerebral paragonimiasis. On angiogram vascular staining and abnormal vessels were not disclosed. On pneumoencephalogram aubcortical atrophy or filling defect of the ventricle may be showed.
5) The predilection area of the granuloma and fibrous.cystic mass were the occipital, posterior parietal and posterior temporal lobes.
6) The patients with chronic stabilized cerebral paragonimiasis, having intractable symptoms and signs, could not be improved with Bithionol treatment. But headache, vomiting, visual disturbance, facial weakness and espscially intractable seizure were improved in our cases treated with surgical operation.
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