Unusual presentations of cerebral hydatid disease in children

Abstract

Three children with hydatid disease of the central nervous system (CNS) were seen. In two patients the lateral ventricles were involved, whilst one case involved the cerebellar hemisphere. In addition, one child presented with a deposit in the maxillary antrum, and deposits were also found in the liver. Operative removal of the deposits was performed, followed by post-operative treatment with praziquantel and albendazole. Investigation of other sites outside the CNS was undertaken for occult lesions. All hydatid cysts were clearly demonstrated on CT, but two cases posed the pre-operative problem of differential diagnosis from arachnoid cysts.

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“…Con menor frecuencia las lesiones son múltiples y en estos casos pueden ser secundarias a embolización por ruptura de quiste intracardiaco 1,2 , accidentes quirúrgicos 5 " 7,9 , muy raro primarios 4 . Se describe que la localización más común es la parietooccipital 1 , sin embargo se ha encontrado quistes en todos los lóbulos cerebrales, ventrículos, cerebelo y médula 1,3 . Asimismo casi siempre que hay compromiso en el sistema nervioso se encuentran quistes en otros órganos 1 , 1 4 .…”

Intact protoscolices and hooklets in cytospin preparation of intra‐operative cyst fluid allow rapid confirmation of rare cerebral intraventricular hydatid infestation

“…The liver and lungs are the common sites of infestation. Cerebral or intraventricular hydatid cysts are rare manifestations, usually encountered in children and young adults 1–4 . They have been reported in patients with patency of the ductus arteriosus 1…”

“…A magnetic resonance imaging (MRI) scan revealed an 8.5 × 7 × 6 cm well‐defined oval cystic lesion of cerebrospinal fluid (CSF) intensity in the right occipital horn (Figure 1a), causing asymmetrical ventricular dilatation. Cysts of infective, inflammatory, developmental or neoplastic aetiology were considered in the differential diagnosis 1,2 . A right temporoparietal craniotomy with total extirpation of the cystic lesion was carried out.…”

Suprasellar hydatid cyst

“…Hydatid disease affects the central nervous system in <3% of cases and usually involves the cerebral hemisphere(s) in the area of middle cerebral artery 1 – 3. Therefore, in a patient presenting with features of raised intracranial tension and characteristic radiology, a diagnosis of hydatid cyst should be considered.…”