Cerebral sparganosis surgery

The scorpion mites are also called sparganosis mansoni. The mites are parasitic in the small intestine of carnivores such as cats, dogs and tigers. The eggs are excreted in the feces, contaminating the water source and hatching coracidium in the water. In the first host, the scorpionfish and the scorpionfish develop into the procercoid, which develops into a plerocercoid in the second host snake, frog, and bird, and the scorpion scorpion is called the scorpion scorpion. Survived in its muscle tissue. Humans drink raw water containing cercaria, ingesting the meat of uncooked snakes, frogs, birds, and snails containing cercariae, or invading the skin and mucosal wounds directly from the cercariae, which can cause schizophrenia. The disease is more common in Southeast Asia, and there are scattered occurrences in Europe, America and Africa. China, Fujian, Guangdong, Guangxi, Zhejiang, Sichuan, Jilin and Jiangsu have reported. It is often invaded into the eyes, cheeks, neck, chest and abdomen wall, breast and scrotum. Cerebral schizophrenia is rare, but it is serious, and it has been reported that the incubation period is 1 to 15 years. The craniotomy pathway is carried out by raw frogs, snakes or drinking water containing cercariae. The cercariae passes through the intestinal wall, through the abdominal cavity, esophageal hiatus, mediastinum, and after reaching the neck, ascending along the carotid or jugular vein. Reach into the skull through the ruptured or jugular foramen. Inflammation occurs around the larvae's colony, forming granuloma and cysts. The larvae can retract and move in the sac, and the larvae can be degenerated or even calcified, but the larvae are often dormant and can still regenerate larvae. The longer the cerebral palsy remains in the brain, the more extensive the damage to the brain tissue. The most common symptoms are epilepsy, dyskinesia, and mental disorders. There are raw snakes, frog meat or drinking untreated raw water history; the sputum specific antibody enzyme-linked immunosorbent assay for blood and cerebrospinal fluid is strongly positive; combined with clinical symptoms, the diagnosis should be considered. Image manifestations of cerebral palsy: 1CT plain scan sees white matter low density, can have small calcification, adjacent ventricular dilatation; enhanced scan can be seen in localized irregular enhancement zone, when there is viability in the brain, when scanning, different time scans, image performance can be different. 2MRI found that calcification is not as good as CT, it can more clearly show white matter degeneration, cortical atrophy and ventricular enlargement; T2 weighted lesions have low signal in the center of the lesion, surrounded by high signal, central irregular increase is inflammatory granuloma Two MRI enhanced scans, enhanced site and shape changes, suggesting that viability worms are moving. Treating diseases: schizophrenia Indication 1. Clinically diagnosed cerebral palsy, after treatment with quinolinone, the symptoms did not improve, imaging showed no improvement in lesions. 2. MRI follow-up study found that two enhanced scans of lesion morphology and site changes suggesting the presence of live worms. 3. The cerebral lobes have been performed, and the postoperative specific antigen ELISA test is positive, suggesting that the surgery is incomplete and there are leftovers. Contraindications 1. A large area of extensive cortical atrophy and white matter degeneration, severe neurological loss, cerebral edema is not heavy, and is located in the functional area. 2. Severe mental changes or dementia, imaging review of stable lesions. 3. After treatment with praziquantel, the symptoms improved, and the specific antigen ELISA test was negative. Preoperative preparation For example, patients with seizures should be controlled frequently, and patients with high intracranial pressure should be treated with proper dehydration. Surgical procedure 1. Design craniotomy incision according to the lesions seen by CT or MRI. After the dura mater is cut, the surface of the granuloma is dark yellow and hard to touch. Usually, the mites are surrounded by a sheath formed by granuloma, which contains necrotic material. Electrocortical soft membrane and cerebral cortex along the lesion area, directly to the granuloma area, incision of the granuloma to absorb the contents of the capsule, worms regardless of degeneration or viability, should be removed and pay special attention to remove the head section, Prevent recurrence. If intraoperative cortical electrogram monitoring is used, epileptic foci and granuloma are removed without damaging the functional area. 2. Some worms have strong activity and can form thin-walled granuloma. If the imaging examination indicates that the lesion is located in the deep part of the brain (such as the basal ganglia), it should be operated under CT or MRI-assisted stereotactic instrument to perform tumor biopsy. Remove the worm from the forceps and take care not to miss the head section, which can greatly reduce the damage to the brain.

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