Binswanger's Disease And Neurocysticercosis

H. Foyaca-Sibat; LdeF Iba?ez-Valdés

摘要

We report seven patients who presented with clinical manifestations of ischemic cerebrovascular disease (CVD), dementia, and on CT Scan radiological signs of active neurocysticercosis and Binswanger's Disease (BD) were found. Two patients died due to bilateral pulmonary thromboembolism secondary to deep venous thrombosis on lower limbs and the others remain alive. In almost all of them after one day of treatment with praziquantel(PZQ) some aggravation of the clinical manifestations of BD were observed. We have hypothesized about the Taenia solium-microglial activation-coagulation disorder and glial disorders-Blood-Brain-Barrier disturbances-Binswanger's disease. We considered that anti-parasitic therapy for active NCC in patients with an associated BD should not be prescribed except for isolated cases when it's extremely necessary. Introduction In 1550, neurocysticercosis (NCC)is described for the first time when Parandi found some rounded vesicles filled of cerebrospinal fluid (CSF) on the corpus callosum in a patient with cerebovascular disease (CVD). In 1558 Kumber provided a more detailed description of NCC from the autopsy of epileptic patient and Malpigh in 1686 nominated its as a parasitic disease and identified the parasites into the intracerebral vesicles which were named cysticercus by Laennec in XIX century.1 NCC is the most common parasitic infection of the brain caused by the larval stage (cysticercus cellulosae) of the pig tapeworm Taenia solium, affecting more than 50 million of peoples all over the world. NCC is characterized by epilepsy, intracranial hypertension, neuropsychiatry manifestation, dermatological and ocular problems, more detailed information about NCC in our region are available on-line.2 3 4 5 In 1672, the English physician Thomas Willis (1621-1672) provides the first accurate clinical observations of patients with post-stroke vascular dementia. Willis said: “ I have observed in many cases that when, the Brain being indisposed, they have been distemper'd with a dullness of mind and forgetfulness, and then afterwards with a stupidity and foolishness, they would afterwards have fallen into a Palsie, which I oft did predict. For according as the places obstructed are more or less large so either a universal Palsies, or an half Palsie of one side, or else some partial resolutions of members happen”.6 In 1938, Dechambre described lacunes for the first time while worked under Cruveilhier supervision at the Salpétriére Hospital in France. The word lacune (French lacune from the Latin lacuna, ae, a tiny hole, pit, or cavity) denotes a small, cystic cavity of the brain substance that usually results from an ischemic infarction in the territory of a penetrating arteriole; lacunes may follow very rarely small deep hemorrhages or an isolated giant dilation of the perivascular space.6 In 1894, Alzheimer and Binswanger described “arteriosclerotic brain atrophy”, a condition characterized by “military apoplexies” or “disease foci” (lacunar infarcts) affecting the basal ganglia, internal capsule, and white matter (WM) of the Centrum ovale, associated with severe arteriosclerosis of small and large vessels.6 he also described an associated enlarged ventricles and normal cerebral cortex, Binswanger separated its from neurosyphillis and other forms of dementia in elderly peoples.7 The term état criblé (Cribiform state) and leukoaraiosis described in 1842 and 1987 respectively refers to the dilations of perivascular spaces around cerebral arterioles in the brain of elderly peoples and the radiological images of loss of density of the periventricular WM observed by computerized tomography (CT) of the brain accordingly.In some textbook of neurology, Binswanger's disease (BD) is described as a very uncommon disorder characterized by pseudobulbar palsy with vascular dementia due to lesions on the WM, and leucoaraiosis (LA) is seen on the CT Scan or MRI in third age's patients (sixth or seventh decade). To the knowledge

机译：我们报告了七名患者，这些患者表现为缺血性脑血管病（CVD），痴呆和CT扫描，发现活动性神经囊尾active病和Binswanger病（BD）的放射学体征。两名患者死于双下肢深静脉血栓，继发于双侧肺血栓栓塞，其余患者仍活着。吡喹酮（PZQ）治疗一天后，几乎所有患者均出现BD临床表现的恶化。我们假设有关Ta虫so虫小胶质细胞活化-凝血疾病和神经胶质疾病-血液-脑-屏障障碍-宾斯旺格氏病。我们认为，除极个别情况下的孤立病例外，不应为伴有BD的患者开具针对活动性NCC的抗寄生虫疗法。简介1550年，当Parandi在患有脑血管疾病（CVD）的患者的call体上发现一些圆形充满囊状脑脊液（CSF）的囊泡时，首次描述了神经囊尾osis病（NCC）。 1558年，Kumber从癫痫患者的尸体解剖中对NCC进行了更详细的描述，1686年，Malpigh将其指定为寄生虫病，并在十九世纪的Laennec将其鉴定为脑囊囊中的囊性囊虫。1NCC是最常见的猪tape虫Ta虫en虫的幼虫期（囊尾cell虫）引起的脑部寄生虫感染，影响了全世界超过五千万人。 NCC的特征是癫痫，颅内高压，神经精神病学表现，皮肤病学和眼部问题，有关该地区NCC的更多详细信息可在线获得。23 4 5 1672年，英国医生Thomas Willis（1621-1672）提供了相关信息。脑卒中后血管性痴呆患者的首次准确临床观察。威利斯说：“我观察到很多情况，当大脑处于混乱状态时，他们会因头脑呆滞和健忘而变得脾气暴躁，然后又因愚蠢和愚蠢而被堕入帕尔西，这是我经常预测的。因为根据所遮挡的地方或多或少，所以要么是一个普遍的麻痹症，要么是一侧的半个麻痹症，否则会发生一些成员的部分决议。” 6 1938年，Dechambre在Cruveilhier的领导下第一次描述了腔隙。法国Salpétriére医院的监督。词腔（来自拉丁词腔的法语词腔，ae，小孔，小凹坑或空腔）表示大脑物质的小囊性腔，通常是由穿透性小动脉区域的缺血性梗塞引起的; 6 1894年，阿尔茨海默病和宾斯旺格描述了“动脉硬化性脑萎缩”，其特征是“军用中风”或“疾病灶”（腔隙性梗塞），影响了腔隙，腔隙可能很少发生。椭圆形中枢的基底神经节，内囊和白质（WM），与小血管和大血管的严重动脉硬化有关。6他还描述了相关的脑室扩大和正常的大脑皮层，Binswanger将其与神经梅毒和其他形式的梅毒分开。 7 184年和1987年分别描述的étatcriblé（楔形状态）和白细胞软化病一词是指老年人大脑中脑小动脉周围的血管周围空间的扩张，以及室壁WM密度降低的放射学图像相应地通过大脑的计算机断层扫描（CT）进行观察。在一些神经病学教科书中，宾斯旺格sease（BD）被描述为一种非常罕见的疾病，其特征在于WM上的病变引起的假性球茎性麻痹并伴有血管性痴呆，在第三年龄段的患者（第六或第七个十年）中，在CT扫描或MRI上发现白斑病（LA）。对知识

Binswanger's Disease And Neurocysticercosis

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