RESUMEN
Neurocysticercosis is the most common parasitic infection of the central nervous system. Neurovascular complications have been recognized as a frequent complication, with up to 10% of strokes in endemic areas being secondary to neurocysticercosis. We report a case of acute transient left hemichorea in an 11-year-old boy with cerebral cysticercosis involving the right middle cerebral artery. Brain magnetic resonance imaging (MRI) revealed T(2)-weighted hyperintensity and gadolinium enhancement in the area surrounding the M1 segment of the right middle cerebral artery. Magnetic resonance angiography showed severe narrowing of the vessel at this site acutely. After treatment with a 1-month course of oral prednisone and initiation of aspirin, our patient had no recurrence of abnormal movements and follow-up magnetic resonance angiography and transcranial Doppler ultrasonography showed resolution of stenosis of the M1 segment.
Asunto(s)
Infarto de la Arteria Cerebral Media/diagnóstico , Infarto de la Arteria Cerebral Media/parasitología , Arteria Cerebral Media/patología , Arteria Cerebral Media/parasitología , Neurocisticercosis/complicaciones , Prednisona/administración & dosificación , Antiinflamatorios/administración & dosificación , Antiinflamatorios no Esteroideos/administración & dosificación , Aspirina/administración & dosificación , Niño , Corea/tratamiento farmacológico , Corea/parasitología , Corea/patología , Gadolinio , Humanos , Infarto de la Arteria Cerebral Media/tratamiento farmacológico , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Masculino , Arteria Cerebral Media/diagnóstico por imagen , Resultado del Tratamiento , Ultrasonografía Doppler TranscranealRESUMEN
A 69-year old man presented with a subarachnoid hemorrhage associated with a large intracerebral hematoma in the right temporal lobe. The oblique views of cranio-orbital computerized tomographic angiography (CTA) were suspicious for an aneurysm on a middle cerebral artery branch. At surgery, a cystic mass was found in the Sylvian fissure, associated with an aneurysm on a distal branch of the anterior temporal artery. The aneurysm was not situated at a bifurcation of the artery and was located beneath the cyst. It was secured by trapping. Pathological examination revealed that the cystic lesion was neurocysticercosis and that the aneurysm was inflammatory. We report a ruptured inflammatory aneurysm of a distal branch of the anterior temporal artery associated with neurocysticercosis, and present the histological findings. We believe this is the first report of such an inflammatory aneurysm with histological confirmation.