ABSTRACT
The purpose of this study was to describe the natural history of untreated cysticercosis as monitored by cranial computed tomography (CT) and correlate it when possible with the pathologic stage of the disease noted at surgery. Serial CT was performed in 113 patients; two to four scans were obtained in each patient. Correlation with surgical specimens and clinical presentation is given. In the early, acute stage, focal nonenhancing areas of edema progress to homogeneously enhancing lesions. In the chronic phase, beginning a few months after infestation, nonenhancing cysts are seen, which later demonstrate ring enhancement. Lesions may then completely resolve or may resolve only to appear later as punctate calcifications. This radiologic progression suggests the need to reevaluate current concepts in therapy and diagnosis of this disorder. Studies on therapeutic efficacy should be based on both the improvement of clinical symptoms and evidence of lesion regression at CT.
Subject(s)
Brain Diseases/parasitology , Cysticercosis/diagnostic imaging , Tomography, X-Ray Computed , Brain Diseases/diagnostic imaging , Humans , Retrospective Studies , Time FactorsABSTRACT
Four young individuals with histories of heavy cocaine abuse occurring several hours to days before the development of acute symptoms of severe headaches, disorientation, and subsequent stupor were shown to harbor subcortical cerebral hemorrhages. Thorough workup of these patients revealed no underlying pathology (i.e., arteriovenous malformations) or other possible causes such as hemorrhage into a tumor. It is well known that heroin, ephedrine, and methamphetamine use may result in cerebral vasculitis, but only one case study in the literature has reported on cerebral vasculitis with ischemic stroke secondary to cocaine abuse. The possibility of heavy cocaine use should be considered, along with the previously mentioned drugs, when a young, previously healthy person presents with a deep cerebral hemorrhage.
Subject(s)
Cerebral Hemorrhage/diagnosis , Cocaine , Substance-Related Disorders/complications , Tomography, X-Ray Computed , Basal Ganglia Diseases/diagnosis , Basal Ganglia Diseases/etiology , Cerebral Angiography , Cerebral Hemorrhage/etiology , Humans , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/etiology , Magnetic Resonance Imaging , Thalamic Diseases/diagnosis , Thalamic Diseases/etiologyABSTRACT
A review of the disease cerebral cysticercosis is presented. The pathogenesis, symptomatology, diagnosis, and treatment of this disease is discussed with an emphasis on the role of computed tomography in the diagnosis of cerebral cysticercosis.
