Primary lumbosacral intradural hydatid cyst revealed by a cauda equina syndrome

Abstract

Hydatid disease is a serious public health problem in developing countries. Spinal hydatid cysts account for 1% of all cases of hydatid disease and the primary intradural extramedullary hydatid cyst is exceptional. We report a case of 75-year-old women presented with a history of backache, leg pain, difficulty in walking, and bladder incontinence. Thoraco-lumbar MRI has showed an intradural process extending from L2 to S5, a low intensity signal on T1 weighted images and a high-intensity signal on T2 weighted images, which were not enhanced after gadolinium injection. There was no vertebral involvement. The patient underwent surgery, by a posterior approach we perform L2S1 laminectomy. After opening the dura multiple vesicles were found scattered among the roots, with no adhesion to meninges or nervous structures. The outcome was good. Albendazole therapy is obligatory.