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Miscellaneous Parasites
Surjith Vattoth, MD, FRCRMiral D. Jhaveri, MD, MBAKaren L. Salzman, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Rare parasitic infection affecting CNS
                • Includes paragonimiasis, schistosomiasis, sparganosis, trichinosis, trypanosomiasis

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        Selected References

                                        1. Silva MAD et al: Schistosomal myeloradiculopathy - a case report. Rev Soc Bras Med Trop. 52:e20180335, 2019
                                        2. Peh WM et al: The tunnel sign revisited: a novel observation of cerebral melioidosis mimicking sparganosis. J Radiol Case Rep. 12(8):1-11, 2018
                                        3. Chu S et al: Magnetic resonance imaging features of pathologically proven cerebral sparganosis. J Int Med Res. 41(3):867-77, 2013
                                        4. Coyle CM: Schistosomiasis of the nervous system. Handb Clin Neurol. 114:271-81, 2013
                                        5. Kampondeni SD et al: MRI findings in a cohort of brain injured survivors of pediatric cerebral malaria. Am J Trop Med Hyg. 88(3):542-6, 2013
                                        6. Li YX et al: Migration: a notable feature of cerebral sparganosis on follow-up MR imaging. AJNR Am J Neuroradiol. 34(2):327-33, 2013
                                        7. Li Y et al: Brain MR imaging changes in patients with hepatic schistosomiasis japonicum without liver dysfunction. Neurotoxicology. 35:101-5, 2013
                                        8. MacLean L et al: Imaging African trypanosomes. Parasite Immunol. 35(9-10):283-94, 2013
                                        9. Nalini A et al: Severe form of radiculo - myelo - neuropathy with meningo - encephalitis secondary to Angiostrongylus cantonensis infection: unusual corpus callosal lesions and serial magnetic resonance imaging findings. Neurol India. 61(4):414-8, 2013
                                        10. Pittella JE: Pathology of CNS parasitic infections. Handb Clin Neurol. 114:65-88, 2013
                                        11. Gong C et al: Cerebral sparganosis in children: epidemiological, clinical and MR imaging characteristics. BMC Pediatr. 12:155, 2012
                                        12. Mohindra S et al: Varied types of intracranial hydatid cysts: radiological features and management techniques. Acta Neurochir (Wien). 154(1):165-72, 2012
                                        13. Potchen MJ et al: Acute brain MRI findings in 120 Malawian children with cerebral malaria: new insights into an ancient disease. AJNR Am J Neuroradiol. 33(9):1740-6, 2012
                                        14. Ross AG et al: Neuroschistosomiasis. J Neurol. 259(1):22-32, 2012
                                        15. Abdel Razek AA et al: Parasitic diseases of the central nervous system. Neuroimaging Clin N Am. 21(4):815-41, viii, 2011
                                        16. Yamasaki K et al: Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris. Neurol Med Chir (Tokyo). 51(9):667-70, 2011
                                        17. George J et al: Cerebral schistosomiasis--an unusual presentation of an intracranial mass lesion. Can J Neurol Sci. 36(2):244-7, 2009
                                        18. Shu K et al: Surgical treatment of cerebellar schistosomiasis. Neurosurgery. 64(5):941-3; discussion 943-4, 2009
                                        19. Chen Z et al: Acute cerebral paragonimiasis presenting as hemorrhagic stroke in a child. Pediatr Neurol. 39(2):133-6, 2008
                                        20. Devine MJ et al: Neuroschistosomiasis presenting as brainstem encephalitis. Neurology. 70(23):2262-4, 2008
                                        21. Ferrari TC et al: Immune response and pathogenesis of neuroschistosomiasis mansoni. Acta Trop. 108(2-3):83-8, 2008
                                        22. Rengarajan S et al: Cerebral sparganosis: a diagnostic challenge. Br J Neurosurg. 22(6):784-6, 2008
                                        23. Kim IY et al: Contralateral migration of cerebral sparganosis through the splenium. Clin Neurol Neurosurg. 109(8):720-4, 2007
                                        24. Silva JC et al: Schistosomiasis mansoni presenting as a cerebellar tumor: case report. Arq Neuropsiquiatr. 65(3B):845-7, 2007
                                        25. Song T et al: CT and MR characteristics of cerebral sparganosis. AJNR Am J Neuroradiol. 28(9):1700-5, 2007
                                        26. Bo G et al: Neuroimaging and pathological findings in a child with cerebral sparganosis. Case report. J Neurosurg. 105(6 Suppl):470-2, 2006
                                        27. Liu HQ et al: Characteristic magnetic resonance enhancement pattern in cerebral schistosomiasis. Chin Med Sci J. 21(4):223-7, 2006
                                        28. Roberts M et al: Cerebral schistosomiasis. Lancet Infect Dis. 6(12):820, 2006
                                        29. Zhang JS et al: MRI features of pediatric cerebral paragonimiasis in the active stage. J Magn Reson Imaging. 23(4):569-73, 2006
                                        30. Gelal F et al: Diffusion-weighted and conventional MR imaging in neurotrichinosis. Acta Radiol. 46(2):196-9, 2005
                                        31. Shahlaie K et al: Parasitic central nervous system infections: echinococcus and schistosoma. Rev Neurol Dis. 2(4):176-85, 2005
                                        32. Klion AD et al: The role of eosinophils in host defense against helminth parasites. J Allergy Clin Immunol. 113(1):30-7, 2004
                                        33. Polat P et al: Hydatid disease from head to toe. Radiographics. 23(2):475-94; quiz 536-7, 2003
                                        34. Patankar TF et al: Adult cerebral malaria: prognostic importance of imaging findings and correlation with postmortem findings. Radiology. 224(3):811-6, 2002
                                        35. Im JG et al: Current diagnostic imaging of pulmonary and cerebral paragonimiasis, with pathological correlation. Semin Roentgenol. 32(4):301-24, 1997
                                        36. Feydy A et al: MRI in a case of neurotrichinosis. Neuroradiology. 38 Suppl 1:S80-2, 1996
                                        37. Kusner DJ et al: Cerebral paragonimiasis. Semin Neurol. 13(2):201-8, 1993
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Rare parasitic infection affecting CNS
                                                      • Includes paragonimiasis, schistosomiasis, sparganosis, trichinosis, trypanosomiasis

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              Selected References

                                                                              1. Silva MAD et al: Schistosomal myeloradiculopathy - a case report. Rev Soc Bras Med Trop. 52:e20180335, 2019
                                                                              2. Peh WM et al: The tunnel sign revisited: a novel observation of cerebral melioidosis mimicking sparganosis. J Radiol Case Rep. 12(8):1-11, 2018
                                                                              3. Chu S et al: Magnetic resonance imaging features of pathologically proven cerebral sparganosis. J Int Med Res. 41(3):867-77, 2013
                                                                              4. Coyle CM: Schistosomiasis of the nervous system. Handb Clin Neurol. 114:271-81, 2013
                                                                              5. Kampondeni SD et al: MRI findings in a cohort of brain injured survivors of pediatric cerebral malaria. Am J Trop Med Hyg. 88(3):542-6, 2013
                                                                              6. Li YX et al: Migration: a notable feature of cerebral sparganosis on follow-up MR imaging. AJNR Am J Neuroradiol. 34(2):327-33, 2013
                                                                              7. Li Y et al: Brain MR imaging changes in patients with hepatic schistosomiasis japonicum without liver dysfunction. Neurotoxicology. 35:101-5, 2013
                                                                              8. MacLean L et al: Imaging African trypanosomes. Parasite Immunol. 35(9-10):283-94, 2013
                                                                              9. Nalini A et al: Severe form of radiculo - myelo - neuropathy with meningo - encephalitis secondary to Angiostrongylus cantonensis infection: unusual corpus callosal lesions and serial magnetic resonance imaging findings. Neurol India. 61(4):414-8, 2013
                                                                              10. Pittella JE: Pathology of CNS parasitic infections. Handb Clin Neurol. 114:65-88, 2013
                                                                              11. Gong C et al: Cerebral sparganosis in children: epidemiological, clinical and MR imaging characteristics. BMC Pediatr. 12:155, 2012
                                                                              12. Mohindra S et al: Varied types of intracranial hydatid cysts: radiological features and management techniques. Acta Neurochir (Wien). 154(1):165-72, 2012
                                                                              13. Potchen MJ et al: Acute brain MRI findings in 120 Malawian children with cerebral malaria: new insights into an ancient disease. AJNR Am J Neuroradiol. 33(9):1740-6, 2012
                                                                              14. Ross AG et al: Neuroschistosomiasis. J Neurol. 259(1):22-32, 2012
                                                                              15. Abdel Razek AA et al: Parasitic diseases of the central nervous system. Neuroimaging Clin N Am. 21(4):815-41, viii, 2011
                                                                              16. Yamasaki K et al: Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris. Neurol Med Chir (Tokyo). 51(9):667-70, 2011
                                                                              17. George J et al: Cerebral schistosomiasis--an unusual presentation of an intracranial mass lesion. Can J Neurol Sci. 36(2):244-7, 2009
                                                                              18. Shu K et al: Surgical treatment of cerebellar schistosomiasis. Neurosurgery. 64(5):941-3; discussion 943-4, 2009
                                                                              19. Chen Z et al: Acute cerebral paragonimiasis presenting as hemorrhagic stroke in a child. Pediatr Neurol. 39(2):133-6, 2008
                                                                              20. Devine MJ et al: Neuroschistosomiasis presenting as brainstem encephalitis. Neurology. 70(23):2262-4, 2008
                                                                              21. Ferrari TC et al: Immune response and pathogenesis of neuroschistosomiasis mansoni. Acta Trop. 108(2-3):83-8, 2008
                                                                              22. Rengarajan S et al: Cerebral sparganosis: a diagnostic challenge. Br J Neurosurg. 22(6):784-6, 2008
                                                                              23. Kim IY et al: Contralateral migration of cerebral sparganosis through the splenium. Clin Neurol Neurosurg. 109(8):720-4, 2007
                                                                              24. Silva JC et al: Schistosomiasis mansoni presenting as a cerebellar tumor: case report. Arq Neuropsiquiatr. 65(3B):845-7, 2007
                                                                              25. Song T et al: CT and MR characteristics of cerebral sparganosis. AJNR Am J Neuroradiol. 28(9):1700-5, 2007
                                                                              26. Bo G et al: Neuroimaging and pathological findings in a child with cerebral sparganosis. Case report. J Neurosurg. 105(6 Suppl):470-2, 2006
                                                                              27. Liu HQ et al: Characteristic magnetic resonance enhancement pattern in cerebral schistosomiasis. Chin Med Sci J. 21(4):223-7, 2006
                                                                              28. Roberts M et al: Cerebral schistosomiasis. Lancet Infect Dis. 6(12):820, 2006
                                                                              29. Zhang JS et al: MRI features of pediatric cerebral paragonimiasis in the active stage. J Magn Reson Imaging. 23(4):569-73, 2006
                                                                              30. Gelal F et al: Diffusion-weighted and conventional MR imaging in neurotrichinosis. Acta Radiol. 46(2):196-9, 2005
                                                                              31. Shahlaie K et al: Parasitic central nervous system infections: echinococcus and schistosoma. Rev Neurol Dis. 2(4):176-85, 2005
                                                                              32. Klion AD et al: The role of eosinophils in host defense against helminth parasites. J Allergy Clin Immunol. 113(1):30-7, 2004
                                                                              33. Polat P et al: Hydatid disease from head to toe. Radiographics. 23(2):475-94; quiz 536-7, 2003
                                                                              34. Patankar TF et al: Adult cerebral malaria: prognostic importance of imaging findings and correlation with postmortem findings. Radiology. 224(3):811-6, 2002
                                                                              35. Im JG et al: Current diagnostic imaging of pulmonary and cerebral paragonimiasis, with pathological correlation. Semin Roentgenol. 32(4):301-24, 1997
                                                                              36. Feydy A et al: MRI in a case of neurotrichinosis. Neuroradiology. 38 Suppl 1:S80-2, 1996
                                                                              37. Kusner DJ et al: Cerebral paragonimiasis. Semin Neurol. 13(2):201-8, 1993