Clinicoradiological findings and treatment outcome in patients with intracranial hydatid cyst

Abstract

Human infection with echinococcus granulosis is a common disease throughout south America, The Mediterranean littoral, The Middle East, Central Asia and East Africa, which usually occur in children and young adults. Formation of avascular cystic lesions in the liver, kidney, pancreas, bones, vitreus and brain can cause protean of signs and symptoms. Intracranial cysts usually present with focal neurological deficit and features of raised intracranial pressure. Primary hydatid disease of the brain is a rare entity but may pose various diagnostic problems. In this study we report the clinicoradiological findings, treatment outcome and some other properties of intracranial hydatid cysts in 24 cases, emphasizing the fact that hydatid cyst should always be suspected in cystic lesions affecting intracranial cavity specially in endemic areas. Sixty five percent of our patients were children and young adults, 85% of whom came from rural areas. We found in contrast to other studies a female predominance (58%). Headache and vomiting were the most common symptoms. All but one of the patients had a solitary lesion in the cerebral hemisphere. In 21/24 (87%), cysts were removed intact. Four patients (three ruptured cysts during surgery and one case with additional cyst in the lung) received mebendazole (800 mg daily). Surgical mortality and postoperative complications were 8.3 and 20.8% respectively.