Cerebral echinococcosis in the children and young adults

Abstract

Background and objective: Echinococcosis or hydatid disease is caused by the larval stage of Taenia echinococcus. Brain involvement in hydatid disease occur in 1% to 3% of all Echinococcus granulosus infections. Intracranial hydatid disease (50% to 75%) are seen in children and account for up to 3.9% of all intracranial space-occupying lesions in many areas. Methods: In our retrospective study, we have reviewed 15 cases of intracranial hydatid disease operated on in our department over a 10-year period. Presenting clinical symptoms and signs and radiologic finding(s) on computed tomography scan and magnetic resonance imaging were reviewed. Results: Twelve (80%) Of Our patients were in the first 2 decades of life (7 boys and 5 girls), aged between I I and 18 (mean: 14.1) years old. Headache, nausea with or without vomiting due to increased intracranial pressure and papilledema were the predominant findings in this group. A spherical cystic lesions, isodense and iso-intense to cerebrospinal fluid on computed tomography and magnetic resonance imaging, was typical. Neither rim enhancement nor perifocal edema was apparent. Concomitant systemic hydatidosis in 2 of our patients involved liver. Extirpation of the cyst without rupture was achieved in all patients. No recurrence or death occurred. Conclusions: Cerebral echinococcosis should be kept in mind in the differential diagnosis of cerebral cystic lesions, especially in the endemic areas, where hydatidosis is a common problem. Intracranial hydatid cysts should always be surgically removed without rupture. Proper preoperative diagnosis is critical for the successful outcome of surgery. The outcome remains excellent for unruptured cysts.