The Clinical Features、iconography、pathologic Analysis Of Cerebral Sparganosis And The Study Of The Relationship Between The Mechanism Of Intracranial Migration And MMP-9、ECF

Objectives:Cerebral sparganosis(CS) is a rare parasitic disease of the central nervous system. It is easy to make a misdiagnosis for the complex and diverse clinical manifestation. Clinical dates were collected from 32 cases with cerebral sparganosis from Jiangxi to summarize the features of clinical manifestations, imaging and pathology, which were to improve the understanding of the disease, so that patients can be got early diagnosis and treatment.In recent years, Matrix metalloproteinases in parasitic diseases has been became an advanced hotspot. While, the activity of MMP-9 is may related to ECF. Measuring the solubility of MMP-9 and ECF from patients’ cerebrospinal fluid, to explore the mechanism of sparganum mansoni intracranial migration and the correlations between MMP-9 and ECF.Material and methods:We have collected clinical data, head CT and dynamic head MRI from 32 patients and pathology from 6 patients with features of CS. All the patients were from the first affiliated hospital Nanchang University and Jiang xi Provincial Institute of Diseases Clinical Department of Parasitology during January 2010 to January 2015. Patients came from Jiangxi province.The level of MMP-9 and ECF in CSF was identified by enzyme linked immunosorbent assay(ElISA) in 10 CS and 10 controls. The differences among the groups were comparable by t test.Results:32 patients(12 females and 20 males) were sporadic, and 1 patient had a history of epidemiology. The main clinical manifestations were epilepsy, headache, hemiplegia, paresthesia, vision disturbance, nausea, vomit, memory decline and somnolence. 19 patients underwent head CT scan. Dot calcification was observed in 16 patients, which was around the patch low density or in middle. 32 patients had enhanced MRI, including ring enhancement in 21, nodular enhancement in 14, tunnel-like enhancement in 2, beaded enhancement in 2, crawl tube-like enhancement in 1. The new and old lesions were coexistence in 15 patients. 6 patients had performed brain pathological examination. A larva was found in 2 cases and eosinophilic granuloma and tunnel-like changes were observed in 4 patients.The level of MMP-9 in CSF of cerebral sparganosis(54.68±18.52) ug/L was significant higher than control group(3.53±1.41) ug/L. Compared to control group, the significant difference was statistically(t = 3.237, P = 0.0080); The level of Eotaxin in CSF of cerebral sparganosis(150.45±20.45) ng/L was significant higher than control group(54.2 ±10.63) ng/L. Compared with control group, the significant difference was statistically(t = 2.925, P = 0.0340).Conclusions:The main clinical manifestations of CS were epilepsy, headaches and paralysis. Patients had typical imaging features and pathological changes. Activated MMP-9 can promote larva migrating in encephalic. ECF plays a positive feedback factor in increasing solubility of MMP-9 in a cascade.