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 11 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.