PMC5180432_01
Left: MRI of lumbar spine showing a hypersignal intensity bead-like lesion on a T2-weighted image in the L4-5 vertebral level (white arrow). Right: the lesion was not enhanced on a contrast image
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F1
L4-5 vertebral level. The lesions were not enhanced with contrast [Figure 1]. Laminectomy in the L4-5 with lesionectomy was performed because we considered a spinal infection resulting in the recent neurological deficits.
Intraoperative findings after laminectomy of the L4-5 demonstrated the presence of spargana (arrow) and clumping of the adjacent nerve roots (arrowhead)
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F2
The lesions were found to be multiple tapeworms between the nerve roots and were completely removed with partial lysis of the adhesions under nerve root monitoring [Figure 2].
Microscopic findings of sparganum indicated thick eosinophilic tegument (black arrow), subtegumental calcospherites (asterisk), and longitudinal strips of muscle (arrowhead)
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F3
Microscopic examination demonstrated the presence of spargana with thick outer eosinophilic teguments and inner calcospherites [Figure 3].
Brain MRI displayed evidence of an old lesion caused by larval migration. This lesion presented as cerebral atrophy with surrounding hypersignal intensity in the left parieto-occipital area on a fluid-atenuated inversion recovery image
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F4
Although brain MRI indicated cerebral atrophy with surrounding hypersignal intensity in the left parieto-occipital area on T2-weighted images, which is compatible with old inflammation, there was no evidence of the live parasite in the brain [Figure 4].