Turkish Neurosurgery
2013 , Vol 23 , Num 4
Primary Multiple Cerebral Hydatid Disease: Still Symptomatic Despite Pathologically Confirmed Death of the Cyst
Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey
DOI :
10.5137/1019-5149.JTN.5826-12.1
Hydatid disease is a life-threatening parasitic infestation caused by Echinococcus granulosus. Infection with E. granulosus typically results in
the formation of hydatid cysts in liver, lungs, kidney and spleen. Majority of the intracranial cysts are secondary and solitary. Multiple primary
cerebral cysts are uncommon. Surgical and medical management of a 14-year-old boy with multiple primary hydatid cysts are presented. 14
cysts, which were symptomatic due to their mass effect, were surgically removed, whereas a deep-seated asymptomatic cyst was followed-up
with medical treatment. Despite proper antibiotic regimen the patient was admitted with epileptic seizures six months later. The deep-seated
lesion was also surgically removed. Intraoperative observations and pathological examination demonstrated different characteristics, with
pericystic gliosis, gel-like cyst content and death scolices within the cavity. In addition to the fact, that the presented case is an additional
example for the rare primary multiple cerebral hydatid cysts, to our knowledge it is the first case of a dead cerebral hydatid cyst, causing
symptoms despite effective medical treatment.
Keywords :
Hydatid cyst, Epilepsy, Cerebral, Multiple, Primary, Dead scolex