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Occlusion of the middle cerebral artery due to cysticercotic angiitis
J Rodriguez-Carbajal1, O H Del Brutto, P Penagos
1Instituto Nacional de Neurologia y Neurocirugía, Mexico City, México.
Insights
Cysticercosis can cause major brain artery blockages, leading to strokes in young individuals. This parasitic infection triggers inflammation and clots, occluding cerebral arteries.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Cerebral infarcts are a significant cause of neurological disability.
- Cysticercosis, a parasitic infection by pork tapeworm larvae, is endemic in many regions.
- Intracranial vascular complications of cysticercosis are not widely recognized.
Observation:
- Three patients with cysticercosis presented with cerebral infarcts.
- Cerebral infarcts were associated with middle cerebral artery or its major branch occlusions.
- Histopathology revealed subarachnoid cysticerci and leptomeningeal thickening.
Findings:
- Parasitic cysts induced inflammatory changes in adjacent blood vessels.
- Inflammation led to occlusive endarteritis and thrombosis of cerebral arteries.
- Endothelial disruption contributed to vascular occlusion.
Implications:
- Cysticercosis should be considered in the differential diagnosis of major intracranial vessel occlusion.
- Early diagnosis and treatment of neurocysticercosis may prevent cerebrovascular events.
- This finding is particularly relevant for young patients in endemic areas.
Abstract:
Three patients with cysticercosis developed a cerebral infarct secondary to the occlusion of the middle cerebral artery or its major branches. Histopathologic examination revealed a large subarachnoid cysticercus surrounding the occluded arteries in two patients and diffuse thickening of the leptomeninges in one. Blood vessels around the parasite showed inflammatory changes that caused either occlusive endarteritis or thrombosis due to disruption of the endothelium. Cysticercosis should be considered as a cause of occlusion of the major intracranial vessels, particularly in young patients living in areas where this disease is endemic.