Transmission: embolic distribution of ova through venous shunts / anomalous migration of adult worms
Cause: granuloma formation
Organism: primarily S. japonicum
- fever, focal neurologic deficits, seizures
Location: cerebellum, cerebral hemispheres, thalamus, dura
CT:
- single / multiple variably enhancing hyperattenuated lesions ± surrounding hypoattenuated edema ← focal granulomatous reaction
- nodular / ring / patchy enhancement
MR:
- bilateral symmetric T1 hyperintensities of globus pallidus + substantia nigra ← manganese deposition related to portosystemic shunt
- “arborized” T1-enhancement pattern with central linear enhancement (? specific)
Organism: primarily S. mansoni + hematobium
- acute / subacute transverse myelitis (common): back pain, urinary retention, motor + sensory disturbances
Location: distal thoracic spinal cord, cauda equina ← presumably via vertebral venous (Batson) plexus
MR:
- T2 hyperintensity ← granulomatous involvement
- “arborized” T1-enhancement pattern
Cx:
- spinal cord compression (by focal granuloma)
- anterior spinal artery syndrome (rare)