Neuroparasitic infections: imaging features and diagnostic algorithms

Neuroparasitic infections are caused by a variety of organisms that affect the central nervous system (CNS). Given the increasing rates of international travel, climate change, and immunosuppression, neuroparasitic diseases represent a major global health concern. Accurate diagnosis relies on non-invasive medical imaging combined with exposure history and laboratory testing. Timely institution of appropriate therapy can drastically improve patient outcomes. This article represents an international collaboration of radiologists on multiple continents to illustrate exemplary radiologic cases and provide a broad literature review of neuroparasitic disorders. We describe the geographic distribution, life cycle, diagnostic testing, and imaging findings for 12 leading neuroparasitic infections: amoebiasis, trypanosomiasis, leishmaniasis, toxoplasmosis, paragonimiasis, neurocysticercosis, hydatidosis, sparganosis, angiostrongyliasis, gnathostomiasis, toxocariasis, and myiasis. A master flowchart is provided to distinguish these diverse entities based on clinical symptoms, geographic area, exposure history, radiologic findings, and clinical testing.