ABSTRACT
Objective To establish an experimental model of acute cerebral schistosomiasis japonica and explore the MRI manifestations of acute cerebral schistosomiasis. Methods Rabbits were divided into 3 groups with 10 rabbits in each group. The rabbits in the experimental group were directly injected with suspension fluid of Schistosoma japonicum eggs(0.9 mg,1 ml) by the cranial drilling method,those in the negative control group were given saline(1 ml)by the same method above-men-tioned,and those in the blank control group were not given any treatment. Antibiotic was given to the first two groups after the op-eration. The clinical manifestations of the 3 groups were observed,and the magnetic resonance imaging(MRI)was performed in 30 days post-operation,and then the brain tissues were taken for pathological examinations. Results All the rabbits in the ex-perimental group exhibited inappetence,various neurological symptoms including hemiplegia,and weight loss after the opera-tion;while those in the negative control group showed inappetence in 3 days after the operation,and 1 week later,the symptom disappeared;there were no adverse reactions in the blank control group. MRI of the experimental group showed nodular or patchy enhancement on T1WI enhancement,brain edema,abnormal ventricular dilatation,and needle augmentation. SWI dis-played hypointense in the abnormal enhanced nodules and flaky hypointense on the operation brain. In the negative control group,2 rabbits showed abnormal enhancement of the needle canal,and 1 showed mild dilatation of the ventricle. The blank control group showed normal manifestations. The pathological examinations showed abnormal appearances in 10 rabbits of the ex-perimental group,including 6 with S. japonicum egg granuloma nodules,nonspecific granuloma nodules coexisted with perivas-cular inflammation;no granuloma nodules were found in the negative control group,but 2 rabbits showed vascular inflamma-tion;the blank control group showed the normal brain tissue. Conclusions An experimental model of acute cerebral schistoso-miasis is successfully established in rabbits by intracranial injection of schistosome eggs. The MRI examination combined with the clinical manifestations can improve the accuracy of early diagnosis of cerebral schistosomiasis.
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Objective To discuss the clinical features of cerebral schistosomiasis. Methods The clinical data of fourteen patients with cerebral schistosomiasis from March 2010 to March 2016 were collected and analyzed retrospectively. Results The schistosomiasis immunological tests of sera and cerebrospinal fluids from the fourteen patients were all positive. Eosinophils increased in ten cases,and the proportion was 5.1％-60.3％. Schistosoma eggs were found in seven cases by the fecal Kato-Katz method. Fourteen cases were all infected with Schistosome japonicum. Twelve cases were diagnosed as chronic type,and two cas-es as acute type. Thirteen patients received medical treatment,of which twelve were cured,and one improved. One patient re-ceived the surgical resection of the lesion. Conclusion The clinical manifestations of cerebral schistosomiasis mainly include seizure,headache,dizziness and fever. In the enhanced head magnetic resonance imaging(MRI),the lesions are clustered and merged into lumps,which is the characteristic image of cerebral schistosomiasis japonica. The praziquantel treatment can achieve a good prognosis.
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Objective To discuss the clinical features diagnosis and treatment of cerebral schistosomiasis. Methods A to?tal of 166 patients with cerebral schistosomiasis were treated and their clinical data were collected and analyzed retrospectively. Results In 166 cases of cerebral schistosomiasis the confirmative diagnoses of 156 cases were diagnosed according to the clin?ical manifestation etiology immunology and auxiliary examination CT MRI .In among 74 cases were confirmed by pathologi?cal examination 10 cases were diagnosed through to the diagnostic treatment. Totally 102 patients received the oral medication of praziquantel and they all improved and discharged 14?16 days later 64 patients received the craniotomy and praziquantel medication after the operation and 48 patients significantly improved others did not improve or aggravated. There was no opera?tive mortality. Conclusions Neuroimaging and laboratory tests are valuable in the diagnosis of cerebral schistosomiasis. The praziquantel treatment is selected firstly when the diagnosis was established. However in the case of serious intracranial hyper?tension intractable epilepsy and praziquantel treatment fails the surgical treatment is required.
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Objective To explore the clinical characteristics and diagnostic methods of cerebral schistosomiasis.Methods The data of CT,MRI and the cerebral spine fluid(CSF) immunoassay in 42 patients with cerebral schistosomiasis were analyzed retrospectively.Results Forty cerebral schistosomiasis patients were diagnosed by the iconography and immunoassay,1 by the postoperative pathological examination and 1 by diagnostic treatment with praziquantel.Conclusions CT and MRI are of great value to determination of the position and nature of the cerebral schistosomiasis.The sensitivity and accuracy of MRI are better for indicating the main pathological changes of the disease than those of CT.The CSF immunoassay plays an important role in the differential diagnosis of cerebral schistosomiasis.
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Two cases of schistosomiasis involving the brain and causing exclusively cerebral symptoms, with complete necropsy protocol in one, are reported. The genesis of the brain lesions is discussed briefly and an explanation is offered as to how ova might appear in the cerebro-spinal fluid obtained by spinal puncture, and thus help establish a clinical diagnosis. It is hoped that the possibility of schistosomiasis of the brain will be entertained in obscure cases with epileptiform convulsions, especially in patients coming from endemic areas. In fact, the disease increases the range of possibilities in the elucidation of any group of obscure cerebral symptoms.(Summary)
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The methods of control of schistosomiasis in mainland China are discussed, namely: treatment of patients, snail control, control of stools, control of surface water supply, and personal protection. Authors experiences in cerebral schistosomiasis are also considered and compared with those of China
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Objective To study the value of CT combined with immune tests for the diagnosis of cerebral schistosomiasis.Methods The data of 24 patients with cerebral schistosomiasis were collected and analyzed retrospectively,and all the patients were examined with CT and serum IHA and ELISA and,in addition,18 patients had the data of cerebrospinal fluid(CSF)IHA and ELISA.Results Twenty-one patients were diagnosed through CT and immune tests,one patients was diagnosed by postoperative pathology,and other two patients were proved by diagnostic therapy with praziquantel.Conclusion CT combined with immune tests has an important value for the diagnosis of cerebral schistosomiasis,and serum immune tests are more simple and more practical than CSF immune tests.
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Objective To explore the risk factors of cerebral schistosomiasis japonica. Methods A total of 37 confirmed cases,diagnosed during 1999-2004 in Anhui Province,were involved in the study as case group. Three controls for each case were selected from the general population either without schistosomiasis,with chronic schistosomiasis or with acute schistosomiasis. The relevant risk factors on the disease were analyzed. Results Four factors with labour intensity, physical, economical and nutritional conditions before illness between case group and normal control group, 7 factors including epilepsy history, hypersensitivity,intensity and times of infection between case group and acute schistosomiasis control group,10 factors including intensity of infection,times of infection and treatment between case group and chronic schistosomiasis control group, all showed statistical significance (p