The infection of the central nervous system (CNS) by schistosome may or may not have clinical manifestations. When symptomatic, neuroschistosomiasis (NS) is one of the most severe presentations of schistosome infection. Among the NS symptoms, cerebral invasion is mostly caused by Schistosoma japonicum (S. japonicum), and the spinal cord symptoms are mainly caused by S. mansoni or S. haematobium. There are 2 main pathways by which schistosomes cause NS: egg embolism and worm migration, via either artery or vein system, especially the valveless perivertebral Batson's plexus. The adult worm migrates anomalously through the above pathways to the CNS where they lay eggs. Due to the differences in species of schistosomes and stages of infection, mechanisms vary greatly. The portal hypertension with hepatosplenic schistosomiasis also plays an important role in the pathogenesis. Here the pathways through which NS occurs in the CNS were reviewed.
血吸虫感染中枢神经系统的症状或有或无。 当中枢神经系统血吸虫病呈现出明确症状时, 其往往是血吸虫感染最为严重的表现之一。 脑型血吸虫病以日本血吸虫感染为主, 而脊髓型血吸虫病则以曼式血吸虫感染为主, 同时也有埃及式血吸虫感染。 关于中枢神经系统血吸虫病虫卵入侵途径, 目前主要存在虫卵栓塞和成虫产卵两种学说, 前者分为动脉栓塞、 静脉栓塞和Batson 椎静脉途径, 成虫亦可循上述途径入侵中枢神经系统产卵。 由于血吸虫种属以及机体感染阶段的差异, 血吸虫进入中枢神经系统的途径亦有所不同。 此外, 肝硬化门脉高压在其入侵过程中也起重要作用。 本文对中枢神经系统血吸虫病入侵途径的研究进展作一综述。