ANTERIOR CEREBRAL-ARTERY TERRITORY INFARCTION IN NEUROCYSTICERCOSIS -EVALUATION BY MR-ANGIOGRAPHY AND IN-VIVO PROTON MR SPECTROSCOPY

Vascular complications of neurocysticercosis are common, but frequentl y not recognized, Mostly these are in the form of an endarteritis invo lving the smaller basal vessels due to basal exudates, Large vessel te rritory infarction has been clearly documented in not more than 10 cas es, All these cases had either a chronic meningeal state or close prox imity of cysts to the vessel wall explaining the vasculitis, We report a case that developed anterior as well as segmental middle cerebral a rtery territory infarction in the acute encephalitic state of neurocys ticercosis. MR angiography showed constriction in the proximal segment of the right anterior cerebral artery, There was no biochemical or im aging evidence of a meningeal reaction, In vivo MR spectroscopy over t he infarction showed absent N-acetyl-aspartate, low creatine and high lactate, This is the first case showing a large vessel territory infar ction in the encephalitic state of neurocysticercosis, with no meninge al reaction, Focal arteritis due to an adjacent brain parenchymal reac tion could be a possible mechanism for the vasculitis. MR spectroscopy may have a potential role in assessing tissue viability and therapeut ic modalities in such infective vasculitis.