Resolution of arterial stenosis in a patient with periarterial neurocysticercosis treated with oral prednisone.
Neurocysticercosis is the most common parasitic infection of the central nervous system. Neurovascular complications have been recognized as a frequent complication, with up to 10% of strokes in endemic areas being secondary to neurocysticercosis. We report a case of acute transient left hemichorea in an 11-year-old boy with cerebral cysticercosis involving the right middle cerebral artery. Brain magnetic resonance imaging (MRI) revealed T(2)-weighted hyperintensity and gadolinium enhancement in the area surrounding the M1 segment of the right middle cerebral artery. Magnetic resonance angiography showed severe narrowing of the vessel at this site acutely. After treatment with a 1-month course of oral prednisone and initiation of aspirin, our patient had no recurrence of abnormal movements and follow-up magnetic resonance angiography and transcranial Doppler ultrasonography showed resolution of stenosis of the M1 segment.
Bouldin
Anthony
A
Division of Pediatric Neurology, University of Washington School of Medicine, Seattle, WA, USA. tbouldin100@yahoo.com
Pinter
Joseph D
JD
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001241:Aspirin / Q000008:administration & dosage; D002648:Child; D002819:Chorea / Q000188:drug therapy / Q000469:parasitology / Q000473:pathology; D005682:Gadolinium; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000469:parasitology* / Q000473:pathology*; D020019:Neurocysticercosis / Q000150:complications*; D011241:Prednisone / Q000008:administration & dosage*; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005682:Gadolinium; D001241:Aspirin; D011241:Prednisone