Intracerebral Alveolar Echinococcosis

Abstract

There are two species of the genus Echinococcus, Echinococcus multilocularis (also called alveolar hydatid) and Echinococcus granulosus, characterized by distinct growth features in humans. The main endemic regions for human alveolar echinococcosis (AE) caused by E. multilocularis are Central Europe, Russia, Turkey, Japan, China, eastern France and North America. Human echinococcosis is usually caused by an intrahepatic growth of parasitic larvae. Cerebral occurrence of E. multilocularis disease is rare, accounting for only 1% of cases, and is generally considered to be fatal. This report presents two cases of intracerebral E. multilocularis disease which occurred in two infected patients with AE pulmonary metastases. The anatomical and clinical features are discussed. Our retrospective survey would indicate that surgical treatment should be envisaged whenever possible.

Multimodality imaging in diagnosis and management of alveolar echinococcosis: an update

“…With central nervous system involvement, neurologic symptoms and findings can occur similar to any other space-occupying lesion. Increased intracranial pressure, chronic headache, dizziness, vomiting, seizures, dysarthria, hemiparesis, aphasia, ataxia, and symptoms related to cranial nerve involvement can develop (7)(8)(9)(10).…”

“…In brain involvement, AE lesions can be confused with various infectious, parasitic, and neoplastic diseases (3,8,10). In osseous and soft-tissue involvement, tuberculosis, primary and metastatic neoplasms should be considered in the differential diagnosis (3).…”

Challenges, Prognosis and Outcomes of Surgical Resection for Hepatic Alveolar Echinococcosis: A Single Centre Experience

“…Metastatic AE is a special challenge. The lesions may spread to the thyroid, bone, vertebra, scrotum, spleen, ovary, heart, kidney, peritoneum, lymph nodes, rectus muscle, knee, lacrimal sac and occasionally the nervous system 22,23 . Cerebral occurrence in AE is approximately 1%, and considered to be fatal.…”

A Case of Alveolar Echinococcosis Presenting as Cerebral and Spinal Intradural Metastases

“…Clinical symptoms of cerebral involvement in alveolar echinococcosis depend on the extent of central nervous system lesions; increased intracranial pressure, epilepsy, neurologic disturbances (e.g., dysarthria, hemiparesis), skull deformity and cranial nerve palsy have been reported [4]. Cerebral dissemination of primary hepatic lesions is often multifocal [5].…”