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논문 기본 정보

자료유형
학술저널
저자정보
Park, Jin-Hoon (Department of Neurosurgery, Asan Medical Center College of Medicine, University of Ulsan) Park, Young-Soo (Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan) Kim, Jong-Sung (Department of Neurology, Asan Medical Center, College of Medicine, University of Ulsan) Roh, Sung-Woo (Department of Neurosurgery, Asan Medical Center College of Medicine, University of Ulsan)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제49권 제4호
발행연도
2011.1
수록면
241 - 244 (4page)

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Sparganosis is a rare parasitic infection affecting various organs, including the central nervous system, especially the lumbar epidural space. This report describes the identification of disease and different strategies of treatments with preoperative information. A 42-year-old man presented with a 2-year history of urinary incontinence and impotence. He had a history of ingesting raw frogs 40 years ago. Magnetic resonance (MR) imaging showed an intramedullary nodular mass at conus medullaris and severe inflammation in the cauda equina. A 51-year-old woman was admitted with acute pain in the left inguinal area. We observed a lesion which seemed to be a tumor of the lumbar epidural space on MR imaging. She also had a history of ingesting inadequately cooked snakes 10 years ago. In the first patient, mass removal was attempted through laminectomy and parasite infection was identified during intra-operative frozen biopsy. Total removal could not be performed because of severe arachnoiditis and adhesion. We therefore decided to terminate the operation and final histology confirmed dead sparganum infection. We also concluded further surgical trial for total removal of the dead worm and inflammatory grannulation totally. However, after seeing another physician at different hospital, he was operated again which resulted in worsening of pain and neurological deficit. In the second patient, we totally removed dorsal epidural mass. Final histology and enzyme-linked immunosorbent assay (ELISA) confirmed living sparganum infection and her pain disappeared. Although the treatment of choice is surgical resection of living sparganum with inflammation, the attempt to remove dead worm and adhesive granulation tissue may cause unwanted complications to the patients. Therefore, the result of preoperative ELISA, as well as the information from image and history, must be considered as important factors to decide whether a surgery is necessary or not.
#Sparganosis #Sparganosis in the lumbar vertebrae #Enzyme-linked immunosorbent assay

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참고문헌 (12)

참고문헌 신청
Bao XY / 2008 / Sparganosis presenting as radiculalgia at the conus medullaris / Clin Neurol Neurosurg 110:843~846 google schola Chang KH / 1998 / MRI of CNS parasitic diseases / J Magn Reson Imaging 8:297~307 google schola Cho SY / 1975 / Some aspects of human sparganosis In Korea / Kisaengchunghak Chapchi 13:60~77 google schola Cho YD / 1992 / Sparganosis in the spinal canal with partial block : an uncommon infection / Neuroradiology 34:241~244 google schola Fung CF / 1989 / Sparganosis of the spinal cord. Case report / J Neurosurg 71:290~292 google schola

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