Two Cases of Cerebral Paragonimjiasis Complicated with Obstructive Hydrocephalus.

Jung, Hee Won; Koh, Young Cho; Han, Dae Hee; Sim, Bo Sung; Chi, Je G

Original Article

Journal of Korean Neurosurgical Society 1979;8(1): 67-74.

Hee Won Jung, Young Cho Koh, Dae Hee Han, Bo Sung Sim, Je G Chi

¹Department of Neurosurgery, College of Medicine, Seoul National University, Seoul, Korea.
²Department of Pathology, College of Medicine, Seoul National University, Seoul, Korea.

ABSTRACT

Two cases of cerebral infestation with Paragonimus westermani complicating obstructive hydrocephalus are presented. The diagnosis was aided by brain CT scan and Conray ventriculogram. Both cases showed a strong positive intradermal test with relevant histories of eating crayfishes in roast form. In simple skull X-ray, one showed characteristic shell-like calcifications over the temporo-occipital region and the other showed multiple round calcifications over the suboccipital region. Brain CT scan demonstrated much more characteristic calcifications with marked ventricular dilatation. Conray ventriculogram disclosed obstructive hydrocephalus in both cases, one at the level of the cerebral aqueduct and the other at the level of the fourth ventricle outlet. Both patients were subjected to ventriculoatrial shunts and concomitant Bithionol therapy with marked improvement. The case involving the cerebellum and the fourth ventricle outlet was submitted to the posterior fossa exploration to be verified as a rare cerebellar paragonimiasis.