Transient cerebral vasculopathy: A rare complication associated with cerebral gnathostomiasis

Abstract

Gnathostomiasis is a common parasitic infection in Southeast Asia, involving many organs in infected human hosts. Common neurological manifestations of Gnathostoma infection include radiculomyelitis, eosinophilic meningitis, and nontraumatic subarachnoid hemorrhage, leading to a high mortality and morbidity. This study first reported transient cerebral vasculopathy, an atypical neurological manifestation, in an 11-year-old Thai girl. The patient was diagnosed with intracerebral and intraventricular hemorrhage, and meningitis with atypical cerebrospinal fluid (CSF) profile. The imaging study of the brain revealed the abnormal white matter lesion and transient cerebral vasculopathy with the cerebral hemorrhage showing a track-like appearance (at the level of the corpus callosum). The serological testing in CSF and serum using the enzyme-linked immunosorbent assay (ELISA) technique was positive for Gnathostoma spinigerum. The patient spontaneously recovered within 3 months without albendazole or corticosteroid treatments.