Angiographic findings in 2 children with cerebral paragonimiasis with hemorrhage

Abstract

<jats:p>Hemorrhagic events associated with cerebral paragonimiasis are not rare, especially in children and adolescents; however, angiographic evidence of cerebrovascular involvement has not been reported. The authors describe angiographic abnormalities of the cerebral arteries seen in 2 children in whom cerebral paragonimiasis was associated with hemorrhagic stroke. The patients presented with acute intracerebral and subarachnoid hemorrhage. Angiography revealed a beaded appearance and long segmental narrowing of arteries, consistent with arteritis. In both patients, involved vessels were seen in the area of the hemorrhage. The vascular changes and the hemorrhage, together with new lesions that developed close to the hemorrhage and improved after praziquantel treatment, were attributed to paragonimiasis. Further study of the frequency and mechanism of hemorrhagic cerebrovascular complications associated with cerebral paragonimiasis is needed.</jats:p>

Cerebral Paragonimiasis with Arteriovenous Malformation in a Child: A Case Report

“…Clinical manifestations of cerebral paragonimiasis are mainly due to parasite migration, ovulation, and production of toxic substances. Intracranial hemorrhage is due to vasculitis and vasospasms [8]; therefore, if intracranial hemorrhage was caused by arteriovenous malformation, the pathological examination would show red cells and hemosiderin. Thus, in this case, the pathological examination showed diffusive clots with inflammatory cell infiltration of predominantly eosinophils, and then the main reason for intracranial hemorrhage was due to cerebral paragonimiasis rather than arteriovenous malformations.…”

Hemorrhagic Stroke and Cerebral Paragonimiasis

“…Chen et al 6 confirmed the existence of focal cerebral vasculitis by digital subtraction angiography, but pathological evidence was lacking. The pathological analysis revealed prominent eosinophilic infiltration and granuloma formation.…”