Cerebral Hydatid Disease Patients Admitted to Duhok City Hospitals: Management and Outcome

Abstract

Background and objectives: The human systemic infestation with Echinococcus granulosus affects the brain in 2% of cases, cerebral hydatid cyst, which presents clinically as slowly growing intracranial mass lesion leading to variable symptomatology of raised intracranial pressure, neurological deficit, and epilepsy. The condition, when occurs, needs prompt surgical removal in order to avoid fatal consequences. The aim of this article is to report clinical data and our experience concerning cerebral hydatid cyst presentation, surgical management, complications, and outcome. Methods: A retrospective case-series study encompassing 8 patients, four females and four males, whose ages ranged between 3.5-35 years, harboring cerebral hydatid cysts, including one cerebral hydatid abscess. The current study was conducted at Duhok Teaching Hospitals, during January 2005-May 2021. The diagnosis was established on clinical and radiological, computed tomography and magnetic resonance imaging backgrounds, and confirmed by operative findings, and histopathology (abscess cyst). Via appropriate craniotomies, all cerebral hydatid cysts, and abscess, were successfully removed, except, the recurrent hydatid cysts which needed an additional posterior fossa craniectomy to achieve total removal. There was no need for the use of advanced statistical system. Results: Compared to their original neurological deficit at presentation, seven cases could achieve complete recovery, except, the patient with recurrence, whose recovery was delayed and suboptimal due to repeated surgeries; there was no mortality. Conclusion: The operating surgeon should practice meticulous care avoiding the possible risk of an accidental rupture during cyst delivery. Various opinions address the pre-operative, intra-operative and post-operative use of Albendazloe, however, we are not sure whether the use of this medication could have prevented the recurrence of CHC which followed the accidental rupture.