[Toxocara canis cerebral vasculitis revealed by iterative strokes]

Rev Neurol (Paris). 2012 Jun;168(6-7):533-7. doi: 10.1016/j.neurol.2012.02.008. Epub 2012 May 23.
[Article in French]

Abstract

Introduction: Cerebral vasculitis is a rare and severe condition, posing problems for diagnosis and treatment. Toxocara canis cerebral vasculitis is exceptionally rare, with only 4 cases having been reported. We report an additional case revealed by iterative strokes.

Observation: A 49-years-old Laotian man presented with right ACA infarction associated with contrast enhancement of cerebrospinal fluid, and multiple segmental stenoses in small and medium caliber encephalic arteries, in a context of hypereosinophilia and chronic headaches. Laboratory tests showed lymphocytic meningitis and T. canis antibody IgE in the blood and CSF. The diagnosis of T. canis cerebral vasculitis was retained. During follow-up, the patient presented again with left pontine hemorrhagic stroke. Conventional cerebral angiography confirmed progression of vasculitis despite treatment.

Conclusion: This case-report illustrates the diagnostic and therapeutic difficulties associated with vasculitis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Albendazole / therapeutic use
  • Animals
  • Anthelmintics / therapeutic use
  • Cerebral Angiography
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / parasitology
  • Headache / etiology
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / cerebrospinal fluid
  • Immunoglobulin E / immunology
  • Infarction, Anterior Cerebral Artery / drug therapy
  • Infarction, Anterior Cerebral Artery / etiology
  • Infarction, Anterior Cerebral Artery / parasitology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pons / pathology
  • Stroke / etiology*
  • Stroke / parasitology
  • Toxocara canis*
  • Toxocariasis / complications*
  • Toxocariasis / drug therapy
  • Toxocariasis / parasitology
  • Vasculitis, Central Nervous System / drug therapy
  • Vasculitis, Central Nervous System / etiology*
  • Vasculitis, Central Nervous System / parasitology

Substances

  • Anthelmintics
  • Immunoglobulin E
  • Albendazole