A Neurotoxocariasis Case Manifesting Multiple Cerebral Infarction and Eosinophilic Meningoencephalitis

Although Toxocara canis is known to cross the blood-brain barrier, central nervous system involvement is uncommon. Clinical manifestations vary and include cerebral infarction, meningoencephalitis, myelitis, vasculitis or seizure. However cerebral infarction and meningoencephalitis rarely occur simultaneously. We report a case of multiple cerebral infarction combined with eosinophilic meningoencephalitis in a patient with neurotoxocariasis. After control of increased intracranial pressure and treatment with albendazole and steroid, the patient’s clinical symptoms improved markedly.

Low-Profile Visualized Intraluminal Support Stent for the Endovascular Treatment of Traumatic Internal Carotid Artery Pseudoaneurysms

Objectives Optimal treatment strategies for traumatic internal carotid artery (ICA) pseudoaneurysms are controversial. The low-profile visualized intraluminal support (LVIS) device is a braided stent with a metal coverage rate between traditional laser cut stents and flow diversion devices. We report here our therapy strategy using the LVIS stent-assisted coiling for treatment of traumatic ICA pseudoaneurysms.Methods Patients with traumatic ICA pseudoaneurysms treated by the LVIS stent-assisted coiling in our center between January 2015 to June 2021 were reviewed. The complications, radiographic, and clinical outcomes of these patients were analyzed.Results A total of 12 pseudoaneurysms in 12 patients were included. Immediate postoperative angiogram showed that six (50%) aneurysms were Raymond grade 1, four (33.3%) were grade 2, and two (16.7%) were grade 3. Two patients with severe primary cranial injury discontinued treatment after the procedure. During the follow-up of the other ten patients, two patients (20%) received additional coiling because of recanalization of the pseudoaneurysm. At the last angiographic follow-up examination, all aneurysms were Raymond grade 1. Postoperative multiple cerebral infarction occurred in two patients. Of the ten patients with a mean clinical follow-up of 32.2 ± 27.9 (median, 18) months, eight patients recovered well, one patient had right hemiplegia, and one patient died of airway damage, which was unrelated to the pseudoaneurysm.Conclusions LVIS stent-assisted coiling was a feasible approach for the treatment of traumatic ICA pseudoaneurysms.

Multiple cerebral infarction linked to underlying cancer: a review of Trousseau syndrome-related cerebral infarction

Trousseau syndrome is a cancer-associated hypercoagulative state leading to venous or arterial thromboembolic events. Cerebral infarction is the most common result of arterial embolism and the pathogenesis is complicated, mainly associated with hypercoagulation and non-bacterial thrombotic endocarditis. On magnetic resonance imaging, multiple lesions are dispersed in more than two territories of the brain, often simultaneously involving the bilateral anterior and posterior circulation. Elevated plasma levels of D-dimer and fibrinogen degradation products may be seen in these patients. There are high rates of short-term recurrence of stroke and sudden death, highlighting the need for early recognition and appropriate treatment of Trousseau syndrome-associated cerebral infarction.