Echinococcosis Of The Brain, Cerebrocystic

Table of contents:

Echinococcosis Of The Brain, Cerebrocystic
Echinococcosis Of The Brain, Cerebrocystic
  • 1 Echinococcosis of the brain
  • 2 Symptoms of echinococcosis of the brain
  • 3 Treatment of echinococcosis
  • 4 Prevention of echinococcosis

A disease called echinococcosis is caused by a small worm. The parasite consists of a head part (scolex), on which there are hooks and suction cups for fast and reliable fixation on the tissues and organs of the host. In addition, there are segments (3-4) on the body of the helminth, the last of which is filled with eggs. A person acts as an intermediate host of the parasite, therefore, the larval or oncospheric stage of development of the helminth causes the disease. The worm can affect any organs (liver, lungs, kidneys), but the disease is most severe if echinococcosis of the brain develops.

Echinococcosis of the brain

echinococcosis of the brain
echinococcosis of the brain

It should be noted that parasitic larvae are resistant to temperature extremes, therefore they can live on the surface of the soil in temperature conditions from 12 to 25 ° C for a month. On the grass, eggs can last up to a crescent. At -30 ° C, they can live up to three years, but at temperatures above + 30 ° C and under the influence of sunlight, they die within a few days.

Echinococcosis of the brain is characterized by the formation of echinococcal cysts in the organ, the walls of which have a two-layer structure:

  • the outer cuticular layer protects the larva from external negative influences;
  • the inner germinal layer is needed for the formation of brood capsules with daughter cysts and scolexes.

Thin legs are used to connect brood capsules with inner cystic membranes. The bubble contains a transparent liquid, which ensures the existence of brood capsules and scolexes. Outside, the entire cyst has a sheath of connective tissue. The brain or other organ, into which the parasite has penetrated, is responsible for the formation of this shell.

This parasite is common in the southern regions of Russia, China, India, Australia, East Africa, some European countries and South America. The final owners of this helminth are carnivores - representatives of the feline and canine families. Only in their intestines can the parasite develop into an adult.

human contact with a sick animal
human contact with a sick animal

Infection occurs when a person comes into contact with a sick animal or a healthy representative, on whose wool there are parasite eggs. They enter the external environment along with the animal's feces, which contain a segment detached from the parasite and filled with these eggs. After going outside, the segment bursts and inseminates everything around with eggs.

The larval stage of echinococcus eggs begins after the establishment of the helminth in the brain. Also at this stage, echinococcal cysts can form. This stage begins about six months after infection.

Initially, the echinococcal cyst in the brain reaches about 1 cm in size, but every year it grows by a couple or three centimeters. Sometimes, if the symptoms of the disease do not appear for a long time, the cyst grows so much that several liters of fluid are placed in it. Several cysts can develop in one organ at once.

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When the helminth dies, the cyst fills with pus and an abscess forms. If the integrity of the cyst is violated, then scolexes and daughter cysts can penetrate into other organs with blood flow and form new cysts there. Moreover, rupture of the membrane of the echinococcal cyst leads to a serious allergic reaction of the body, up to anaphylactic shock. Sometimes this becomes the cause of death of the patient.

Multifocal cysts in the brain are rarely diagnosed. They are:

  • secondary (appear due to rupture of a cyst, injury or after surgery);
  • primary (occur when scolexes enter the brain with the bloodstream).

Symptoms of echinococcosis of the brain


The disease can progress over several years. In this case, the symptoms of cerebral echinococcosis are gradually increasing. They are caused by the pressure of the cyst on the organ tissue. The clinical picture of echinococcosis is very similar to brain tumors, since in both cases, neoplasms gradually grow in the organ.

Cerebral echinococcosis begins with hydrocephalic syndrome, which is characterized by the following manifestations:

  • headaches;
  • epileptic seizures with the subsequent development of paresis;
  • nausea and vomiting;
  • deterioration of vision;
  • dizziness.

It is painful for the patient to move the eyeballs, and when examining the fundus, stagnation of the discs of the optic optic nerves is found. Depending on the localization of the cyst, a variety of focal symptoms develop, which most often manifest themselves in a violation of the ability to read, write or count. In addition, speech, vision suffers, muscle weakness and a decrease or complete loss of sensitivity occur.

In addition, echinococcosis of the brain is accompanied by the following mental and mental disorders:

  • rave;
  • dementia;
  • hysterical seizures;
  • memory impairment;
  • hallucinations;
  • psychosis.

If the parasite dies, a non-absorbable cyst remains in the brain, inside which calcium salts begin to be deposited. Eosinophils can be found in the cerebrospinal fluid, which should normally be absent there. Also in the cerebrospinal fluid, an excess of the concentration of leukocytes and the presence of protein are diagnosed.

With echinococcosis of the brain, a syndrome of hypertension (intracranial) appears, which is characterized by focal neurological manifestations and severe edema of the optic optic nerve discs.

Echinococcosis treatment

MRI of the brain
MRI of the brain

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As a rule, laboratory diagnosis of echinococcosis of the brain is usually difficult:

  1. Eosinophilia in the KLA is observed in only one third of patients.
  2. A positive reaction Cazzoni is diagnosed only in 2/3 of patients.
  3. RSK is informative in a maximum of 75% of cases.
  4. RNGA and ELISA are effective in 85 percent of patients.

To diagnose echinococcus brain, it is necessary to do CT, MRI and ultrasound of other organs. So, if cysts are also detected in the liver, this will help facilitate the diagnosis of intracranial disease.

The main diagnostic techniques are MRI and CT. Also, when making a diagnosis, it is important to consider the following concomitant factors:

  1. Serous meningitis and short-lived epileptic seizures;
  2. The patient's complaints about unreasonable attacks of hyperthermia;
  3. The presence of focal brain lesions against the background of slow progression of the disease;
  4. The data of the study of cerebrospinal fluid by the chemiluminescence method must be taken into account.

The main treatment for echinococcosis of the brain is surgical. After surgical removal of the cyst, the patient is prescribed antiparasitic drugs. To remove cysts, a neurosurgery method is usually used, that is, a microsurgical dissection technique. It is important to remove the cyst without damaging the capsule, since in the case of seeding of brain tissue with scolexes, an immediate anaphylactic reaction develops.

It is especially difficult to treat multiple brain lesions. In this case, each cyst is removed by a microsurgical method without opening the lumen. With the localization of cystic formations in functionally significant brain areas, the operation is carried out with constant neuro-physiological monitoring.

With regard to conservative treatment, the most effective drug for echinococcus is Albendazole. In addition, the following analogs of Albendazole can be used in therapy:

  • Andazole;
  • Zentel;
  • Escazol;
  • Nemozole.

Postoperative anthelmintic treatment is very important for the high efficiency of therapy, since in this case it is possible to eliminate parasites of a very small size, which cannot be detected using modern diagnostic techniques.

If a cyst ruptured during the operation or puncture treatment was used, for preventive purposes, Praziquantel is prescribed immediately after the operation on the basis that 40 mg of the drug is needed for each kg of patient weight. This therapy is continued for two weeks. After treatment with Praziquantel, Albendazole is prescribed - 10-15 mg / kg. This medication is taken for 3-12 months.

If the capsule was removed without rupture, then the prognosis is favorable. But if there was an infection with scolexes of the cerebrospinal fluid zones, after a couple of years, the disease may relapse. In this case, multiple cysts are formed, which often lead to the death of the patient.

Prevention of echinococcosis

The main prevention of this ailment is the observance of sanitary and hygienic standards. Since animals are carriers of eggs, hands should be washed after contact with street dogs, domestic dogs and cats. Also, for preventive purposes, it is important to wash greens and fruits before use, as well as to refuse to drink water from open reservoirs.


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