Kyste hydatique cérébral chez l’enfant

Abstract

We here report the case of a 6-year-old girl living in a rural area referred to our emergency department with persistent headaches progressing for more than three months, associated with vomiting and memory disorders. These headaches had worsened in the last 3 weeks before hospitalisation. Clinical examination showed conscious patient with isocore reactive pupils, upper limb tremors associated with balance and walking disorders. Vital signs were: blood pressure 10/65 mm Hg, heart rate 130 beats/minute, spo2 of 98% in ambient air and temperature 37,5°C. Brain CT scan showed bulky, non enhancing, left frontal cyst formation with compression of the medial structures and of the ipsilateral ventricular system, suggestive of a hydatid cyst of the brain (A). Abdominal ultrasound and chest X-ray did not show any other site of involvement. The patient underwent emergency surgery carried out by neurosurgery team. The cyst was removed without breaking it using hydropulsion (B). In the postoperative period after surgery the patient was conscious without motor deficit, with disappearance of clinical signs of intracranial hypertension (ICHT). The diagnosis of cerebral hydatid cyst should be suspected in patients with signs of progressive ICHT, living in endemic areas. Early brain CT scan should be performed to allow for diagnosis and surgical treatment is essential to avoid neurological sequelae.