Ninety-five Cases Analysis Of Cerebral Parasitic Disease

Objective: To summarize the experience of epidemiology,clinical features,imaging features,diagnosis,treatment and follow-up of hospitalized patients with cerebral parasites in the First Affiliated Hospital of Guangxi Medical University in the past 5 years.Methods: We retrospectively analyzed 95 cases of cerebral parasites with complete data admitted to the Department of Neurosurgery and Department of Infectious Diseases of the First Affiliated Hospital of Guangxi Medical University from August 2012 to July 2017.According to the inclusion criteria and exclusion criteria,there were 93 cases of cerebral cysticercosis and 3 cases of cerebral sparganosis.Recorded and analysis 95 cases of cerebral parasitosis related data: age,gender,work type,epidemiological history,disease course,clinical manifestations,laboratory tests,imaging data,diagnosis,treatment and follow-up.The Chi-squared Test was used to analyze the relationship between the number,location,staging,disease course of cerebral cysticercosis lesions and surgical intervention.Results: The age range was 12 to 75 years and the average age was 45.2 years;78 cases(82.1%)were males and 17 cases(17.9%)were females.61 cases(66.3%)of patients with cerebral cysticercosis had raw pork and pig blood.In this group which patients with cerebral sparganosis,2 had applied raw frog meat to the wound,and 1 had eaten raw frog meat.The disease duration ranged from 3 days to 30 years,including 59 cases(62.1%)within 1 year,26 cases(27.4%)from 1 to 5 years,6 cases(6.3%)from 6 to 10 years,and 4 cases over 10 years(4.2%).The main clinical manifestations were seizures(52.6%),headache(42.1%),dizziness(27.4%),and fatigue(15.8%).CT or MRI showed vesicular lesions,calcifications,hydrocephalus,patchy shadows,ring-enhanced shadows,tunnel signs,bead-like signs,and other imaging findings.71 cases(74.7%)were diagnosed with cerebral parasitosis at the first visit.The rate of misdiagnosis was 25.3%.They were misdiagnosed as tumors in 12 cases(12.6%),epilepsy in 7 cases(7.4%),and encephalopyosis in 5 cases(5.3%).Medical therapy was performed in 66 cases(69.5%)and surgical treatment in 29 cases(30.5%).Conclusions: Cerebral cysticercosis is related to raw pork and pig blood,and cerebral sparganosis is related to raw frog meat and frog meat.CT and MRI contribute to the diagnosis of the above two diseases,but still need to be carefully identified.If patients have intracranial occupancy effects and hydrocephalus with high intracranial pressure symptoms,they need surgical intervention.