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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(07): 765-766
DOI: 10.1055/s-0042-1755214
Images in Neurology

High-resolution vessel wall imaging in human neurocysticercosis with leptomeningitis

Imagens de alta resolução das paredes dos vasos na neurocisticercose humana, com leptomeningite
Luiz Fernando Monte Borella 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas SP, Brazil
,
Dafny Soares Leitao 
2   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Infectologia, Campinas SP, Brazil
,
Eduardo de Oliveira Narvaez 
3   Hospital Beneficência Portuguesa de São Paulo, Departamento de Radiologia, São Paulo SP, Brazil
,
Marcelo de Carvalho Ramos 
2   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Infectologia, Campinas SP, Brazil
,
Fabiano Reis 
1   Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas SP, Brazil
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The high-resolution vessel wall imaging (HR-VWI) is a millimetric technique that demonstrates vessel wall inflammation, which can occur simultaneously with leptomeningitis. Encephalic infarction may be observed in less than 50% of the cases.[1] [2] [3]

A 42-year-old man with neurocysticercosis, presented headache and visual blurring. Magnetic resonance imaging (MRI) and HR-VWI scans were performed, as demonstrated in [Figures 1] and [2], respectively. The findings contribute to the pathophysiology of the disease, by demonstrating concentric and irregular wall enhancement (vasculitis). The degree of vessel involvement correlates with the severity of disease stage,[1] and was demonstrated in other infections, such as syphilis,[4] and tuberculosis,[1] [5] but not in neurocysticercosis.

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Figure 1 Axial Fast Imaging Employing Steady-state Acquisition (FIESTA) images (A and B): cystic lesions in the subarachnoid space. Axial T1 post-contrast (C and D): a nodular lesion with peripheral contrast enhancement in the left calcarine region (arrow) and leptomeningeal enhancement (arrowhead). The MIP axial TOF MRA and DWI images (E and F) showed no significant abnormalities. Abbreviations: DWI, Diffusion-weighted imaging; MIP, Maximum Intensity Projection; MRA, Magnetic Resonance Angiography; TOF, Time-Of-Flight.
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Figure 2 Axial HR-VWI pre (A) and post-contrast (B) demonstrate smooth enhancement in both M1 middle cerebral arteries.

Authors' Contributions

LFMB: conceptualization, data curation, investigation, writing-original draft; DSL: conceptualization, data curation, investigation; EON: conceptualization, visualization, writing-review & editing; MCR, FR: conceptualization, formal analysis, project administration, visualization, writing-review & editing.




Publication History

Received: 17 January 2022

Accepted: 07 March 2022

Article published online:
29 September 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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