Cerebral cysticercosis에 대한 임상 고찰

Abstract

[영문]

[한글]

뇌낭미충중은 국내에서 호발되는 중추신경계를 침범하는 난치성의 기생충감염이었으나

뇌전산화 단층촬영술이 도입된 이래로, 진단과 치료에 많은 진전을 보였다. 저자는 뇌낭

미충증의 임상경과를 파악하고 부위에 따른 치료결과를 알아보기 위하여 1972년 7월부터1

983년 6월까지 연세의대 신경외과에 입원했던 뇌낭미충증환자 94명을 분석하였는데 이중

47명의 환자에서 52회의 수술을 시행하였으며 결과는 다음과 같다.

1. 뇌전산화 단층촬영이 도입된 이래로, 뇌낭미충증의 진단이 종전보다 용이하여 졌으

며 발생빈도는 약 2배로 증가하였다.

2. 뇌낭미충증은 2 : 1로 남자에 더 많았으며 40대 연령층이 제일 많았다.

3. 뇌실질형이 제일 많았고(45.4%), 다음이 뇌실형의 순이었다(36.0%).

4. 임상증상으로는 뇌압상승소견이 87.3%에서 있었으며, 주로 뇌실형에서 많았고, 전간

증이 64.9%로 뇌실질형에서 주로 관찰하였다.

5. 피하결절은 44.7%의 환자에서 볼 수 있었다.

6. 임상병리검사 소견은 진단에 큰 도움이 되지못했다.

7. 뇌전산화 단층촬영상에서 저밀도의 낭성병소는 95.4%에서 나타났으며, 뇌수종은 52.

3%, 조영제 대조강화는 20.0%, 석회화 침착은 9.1%에서 보였다.

8. 수술은 후두와 개두술이 55.8%로 재일 많았으며, 수술후 사망은 1예(1.9%)있었다.

9. 21명의 환자는 신경학적 장애 및 전간증에서 완전회복되었으며 증세호전이 없었던

경우는 19.1%이었다.

Clinical analysis of cerebral cysticercosis

Do Heum Yoon

Department of Medical Science The Graduate School, Yonsei University

(Directed by Prof. Kyu Chang Lee, M.D.)

Cerebral cysticercosis is unfortunately a not uncommon disease in Korea, which

was a hardly manageable parasitic infestation on the central nervous system. After

the introduction of the brain C-T scan, diagnosis and treatment of cerebral

cysticercosis were improved maktedly. The author analyzed 94 cases of cerebral

cysticercosis who had been admitted to the Department of Neurosurgery and

Neurology, Yonsei University Medical School from July 1972 to June 1983.

Of the 94 patients. 52 operations were performed in 47 patients. The analysis and

evaluation were made with particular emphasis on brain C-T scan finding.

1. After the introduction of the brain C-T scan, diagnosis and operation of

cerebral cysticercosis were increased to two times.

2. Carebral cysticercosis was more common in men than women(2:1) and the most

prevalent age was the 5th decades.

3. The parenchymal type of cerebral cysticercosis was most common (45.4%) and

ventricular type was the next (36.0%).

4. Presenting clinical manifestations were symptoms of increased intracranial

pressure (87.3%) which was prominent in ventricular type, and seizure (64.9%) which

was frequently observed in parenchymal type.

5. Subcutaneous cysticercosis was observed in 44.7%.

6. Clinical laboratory was not helpful for diagnosis of the cerebral

cysticercosis.

7. The brainn C-T scan showed hydrocephalus in 52.3%, contrast enhancement in

20.0% and calcification in 9.1%.

8. Posterior fossa exploration was performed in 55.8%. The over all operative

mortality was 1.9%.

9. Twenty-one patients were completely recovered from neurologic deficits and or

seizure. In 19.1% of the cases showed no improvement.