Background

We investigated the proportion of pediatric patients with cerebral paragonimiasis and intracranial hemorrhage who have intracranial pseudoaneurysms.

Methods

Images of 17 pediatric patients with cerebral paragonimiasis that first manifested as secondary intracranial hemorrhage were evaluated. All patients underwent computed tomographic angiography before surgery. A diagnosis of cerebral paragonimiasis was confirmed based on a positive Paragonimus-specific antibody test in serum samples from all 17 patients. Cerebral paragonimiasis in five of the 17 patients was further confirmed by histopathological examination of surgical specimens.

Results

Computed tomographic angiographic images for six of the 17 patients (35.3%) showed the presence of intracranial pseudoaneurysms. Follow-up computed tomographic angiographic scans two years later showed that two of the six patients had persistent pseudoaneurysms and underwent aneurysmectomy. The diagnosis of pseudoaneurysm was confirmed by histopathological examination postsurgery. In another two of the six patients, the pseudoaneurysm lesions were absorbed and could no longer be seen on three- to six-month follow-up scans. The final two patients with pseudoaneurysms are still under follow-up. Intracranial pseudoaneurysms with various degrees of surrounding hemorrhage were frequently observed at first manifestation.

Conclusions

The rupture of intracranial pseudoaneurysms is a common characteristic feature of secondary intracranial hemorrhage caused by cerebral paragonimiasis in pediatric patients.

中文翻译：

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小儿脑性肺吸虫病引起的颅内假性动脉瘤。

背景

我们调查了颅内假性动脉瘤的儿童肺吸虫病和颅内出血患儿比例。

方法

评价了17例首次表现为继发性颅内出血的小儿脑性肺吸虫病患者的图像。所有患者在手术前均进行了计算机断层血管造影。根据对所有17例患者的血清样本中的肺吸虫特异性抗体试验呈阳性反应，证实了对脑肺吸虫病的诊断。通过手术标本的组织病理学检查进一步证实了17例患者中有5例发生脑肺吸虫病。

结果

17例患者中有6例（35.3％）的计算机断层血管造影图像显示存在颅内假性动脉瘤。两年后的后续计算机断层血管造影检查显示，六名患者中有两名患有持续性假性动脉瘤并接受了动脉瘤切除术。假性动脉瘤的诊断已通过组织病理学检查术后证实。在六名患者中的另外两名中，假性动脉瘤病变被吸收，并且在三至六个月的随访扫描中不再可见。最后两名假性动脉瘤患者仍在随访中。在首次表现时经常观察到颅内假性动脉瘤伴有不同程度的周围出血。

结论

颅内假性动脉瘤破裂是小儿脑积水所致继发性颅内出血的常见特征。