• Marwa Ibrahim, Khaled Gad, Tufail Khan, Waleed Yousef, Zafdam Shabbir, Mustafa Najibullah, Wael T Abodief, Hussain H Jarkhi, and Waleed A Azab.
• Tropical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Infection Control Department, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait.
• World Neurosurg. 2024 Apr 1; 184: 5135-13.

AbstractPseudotumoral encephalic schistosomiasis (PES) is the chronic form of cerebral neuroschistosomiasis, and is rarely encountered in clinical practice. Clinically, PES closely resembles other intracranial space-occupying lesions including brain tumors. Laboratory investigations are usually inconclusive, and neuroradiologic findings are frequently reported as non-specific. Such diagnostic difficulties may result in delayed diagnosis and treatment. Across the literature, there is a paucity of information about and controversy over many aspects of the disease. Particularly, inconsistent magnetic resonance imaging (MRI) findings, a wide variation of medical treatment protocols, lacking consensus regarding the indications of surgery, and undetermined information regarding the impact of the extent of resection on prognosis. We herein review the pertinent literature with the aim of providing focused information regarding the pathogenesis of PES, its currently identified more distinctive neuroimaging features, and the indications and extent of surgery in light of the state-of-the-art operative neurosurgical practice. A distinctive multinodular arborizing pattern of PES lesions can often be observed on MRI in patients with PES. Praziquantel is considered by many authors to be the drug of choice in all cases, and seems to be effective at variable dose regimens. Although lesion excision utilizing current technology is generally safe, the indications and extent of surgery are still undetermined and should be decided on a case-by-case basis. Multicenter collaborative research is further needed to fill the existing gaps in the current knowledge on PES.Copyright © 2023 Elsevier Inc. All rights reserved.

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