Chagas Disease can rarely involve the central nervous system.
The involvement of the CNS may be acute or chronic.
Involvement of the CNS during an acute infection does not occur in most patients and if it does occur it is usually asymptomatic. A few patients may develop a nodular multifocal encephalitis, which is often fatal.
Chronic disease presents as a reactivation in immunosuppressed patients (HIV, lymphoma, transplant, etc). Patients develop an encephalitis which may show necrotizing features. Tumoral or pseudotumoral masses with numerous amastigotes may develop (CNS chagoma).
A patient with chagasic cardiomyopathy may develop multifocal ischemic change as a result of hypoxic episodes, thromboemboli and hypotension.
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