Cerebral echinococcosis in children

Abstract

Background & objective: Echinococcosis or hydatid disease is caused by the larval stage of taneia echinococcus. Brain involvement in hydatid disease occurs in 1-3% of all echinococcus granulous infections. Fifty to seventy percent of intracranial hydatid disease are seen in children and account for up to 3.9% of all intracranial space-occupying lesions. Methods: In our retrospective study, we have reviewed 15 cases of intracranial hydatid disease operated on in our hospital over a 10-year period. Presenting clinical symptoms and signs and radiological findings on computed tomography and magnetic resonance imaging (MRI) were documented. Results: Twelve (80%) of our patients were children (7 boys and 5 girls), aged from 11 to 18 (mean 14.1 years). Headache and vomiting due to increased intracranial pressure and papilloedema were the predominant findings in this group. Computed tomography and MRI revealed a spherical cystic lesion, isodense and iso-intense respectively to cerebrospinal fluid, with no rim enhancement or perifocal oedema. Assodated systemic hydatidosis in 2 of our patients involved the liver. Extirpation of the cyst without rupture was achieved in all patients. We had no recurrence or death. Conclusion: Intracranial hydatid cysts should always be surgically removed without rupture. The outcome remains excellent in these cases and correct preoperative diagnosis is vital for the successful outcome of surgery. Cerebral echinococcosis should be kept in mind in the differential diagnosis of cystic lesions. p(73-76).