RESUMO
Human African trypanosomiasis (sleeping sickness) is a parasitic tropical disease endemic to sub-Saharan Africa. Due to migration and holiday travel patterns cases are increasing in the United Kingdom. The neurological sequelae have dental management implications both directly from the consequent physical disability and indirectly from the oral side-effects of the medications used to manage symptoms. Changes in disease demographics require the dental profession to increase its awareness of migration medicine and the appropriate dental management of such diseases.
Assuntos
Infecções Parasitárias do Sistema Nervoso Central/complicações , Doenças dos Nervos Cranianos/etiologia , Assistência Odontológica para Doentes Crônicos/métodos , Paralisia Pseudobulbar/complicações , Medicina Tropical , Tripanossomíase Africana/complicações , Adulto , Infecções Parasitárias do Sistema Nervoso Central/parasitologia , Doenças dos Nervos Cranianos/parasitologia , Transtornos de Deglutição/complicações , Transtornos de Deglutição/terapia , Assistência Odontológica para a Pessoa com Deficiência/métodos , Humanos , Masculino , Planejamento de Assistência ao Paciente , Paralisia Pseudobulbar/parasitologia , Trypanosoma brucei rhodesiense , Tripanossomíase Africana/parasitologia , Xerostomia/complicações , Xerostomia/terapiaRESUMO
Brain involvement with hydatid disease occurs in 1-2% of all Echinococcus granulosus infections. Cerebral hydatid cysts are usually supratentorial, whereas infratentorial lesions are quite rare. Here we report a 19-year-old man with hydatid cysts in the right cerebellopontine cistern with the involvement of internal acoustic canal and jugular foramen. The patient presented with signs of increased intracranial pressure and multiple cranial nerve palsies. Surgery was performed in the semi-sitting position using a lateral suboccipital approach for a right-sided craniotomy. Magnetic resonance imaging clearly demonstrated cisternal, neural and vascular relationships which aided in intact surgical removal of the lesion using microsurgical techniques. Total removal without rupture should be the surgical goal in all hydatid cysts.
Assuntos
Doenças Cerebelares/parasitologia , Ângulo Cerebelopontino/parasitologia , Doenças dos Nervos Cranianos/parasitologia , Equinococose/cirurgia , Imageamento por Ressonância Magnética , Adulto , Doenças Cerebelares/diagnóstico , Doenças Cerebelares/cirurgia , Ângulo Cerebelopontino/irrigação sanguínea , Ângulo Cerebelopontino/diagnóstico por imagem , Ângulo Cerebelopontino/cirurgia , Doenças dos Nervos Cranianos/diagnóstico por imagem , Doenças dos Nervos Cranianos/cirurgia , Equinococose/complicações , Equinococose/diagnóstico , Humanos , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/parasitologia , Hipertensão Intracraniana/cirurgia , Veias Jugulares , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/parasitologia , Doenças do Labirinto/cirurgia , Masculino , Radiografia , Resultado do TratamentoRESUMO
Angiostrongylus cantonensis is the most common etiological agent of eosinophilic meningitis. Adults are harbored in the pulmonary arteries of rats. Larvae develop within various natural (mollusks) and paratenic (snails...) hosts. After ingestion, larvae reach the human central nervous system where they cannot complete their life cycle. This zoonosis is usually seen in Southeast Asia and South Pacific islands. Nevertheless, a few imported cases have been reported in Western countries, possible because of the incubation delay. Mild meningeal irritation signs, paresthesia, cranial nerve abnormalities (i.e: II, III, VI, VII) are the most usual by encountered signs. Severe cases with brain involvement have been reported. In endemic areas, typical clinical signs associated with C.S.F. eosinophilic pleocytosis allow the diagnosis but Elisa test may be useful. Prognosis is always excellent even if headache and malaise may last a few weeks. No antihelminthic agent is efficient against Angiostrongylus cantonensis. Prophylaxia by public health counselling program is fruitful.
