Cerebral Cystic Echinococcosis: A Child with a Giant Hydatid Cyst

Page: [38 - 41] Pages: 4

  • * (Excluding Mailing and Handling)

Abstract

Aim: Raising awareness of healthcare providers about headache and early morning vomiting in children.

Background: Intracranial cystic hydatid disease (Echinococcosis) is a rare worldwide disease caused by encysted larvae of the dog tapeworm Echinococcus granulosa. Human is the intermediate host of this parasite and CNS involvement occurs in only 3%. Clinically, the cyst causes a seizure, increased intracranial pressure and/or focal neurological deficit. Surgical removal of the intact cyst by the Dowling technique is the treatment. A 4-year-old girl was referred to a neurosurgery clinic with a history of headache and early morning vomiting over the previous 2 months. Neurological examination revealed right hemiparesis and bilateral papilloedema. Emergency brain CT-scan revealed a huge intracranial cystic lesion with midline shift. Emergency craniotomy was done and the cyst was removed intact without complication and sent for histopathological examination. The patient was discharged from the hospital with full recovery.

Keywords: Hydatid Cyst, Tapeworm, Cerebral, Craniotomy, Child, Hemiplegia, Papilledema.

[1]
Mark S. Greenberg handbook of neurosurgery Eighth edition2016 Parasitic infection of the CNS. 2016; p. 375.
[2]
Oscar H. Del Brutto, Juan J Figueroa, Hector H Garcia Parasitic infections. 6th ed. Youmans Neurological Surgery 2011; Vol. 1: pp. 625-6.
[3]
Schantz PM. Echinococcosis Guerrant RL Walker DH Weller PF Tropical Infectious Diseases Principles, Pathogens & Practice. Churchill Livingstone Philadelphia 1999; pp. 1005-25.
[4]
Singounas EG, Leventis AS, Sakas DE, Hadley DM, Lampadarios DA, Karvounis PC. Successful treatment of intracerebral hydatid cysts with albendazole: Case report and review of the literature. Neurosurgery 1992; 31(3): 571-4.
[http://dx.doi.org/10.1227/00006123-199209000-00022] [PMID: 1407437]
[5]
Moro PL, Gonzalez AE, Gilman RH. Cystic hydatid disease Strickland GTHunter’s Tropical Medicine and Emerging Infectious Diseases. 8th ed. WB Saunders Philadelphia 2000; pp. 866-71.
[6]
Tuzun Y, Kadioglu HH, Izci Y, Suma S, Keles M, Aydin IH. The clinical, radiological and surgical aspects of cerebral hydatid cysts in children. Pediatr Neurosurg 2004; 40(4): 155-60.
[http://dx.doi.org/10.1159/000081932] [PMID: 15608487]
[7]
Ray M, Singhi PD, Pathak A, Khandelwal NK. Primary multiple intracerebral echinococcosis in a young child. J Trop Pediatr 2005; 51(1): 59-61.
[http://dx.doi.org/10.1093/tropej/fmh059] [PMID: 15601656]
[8]
Ameli NO, Abbassioun K. Hydatid disease of central nervous system. 1st ed (Persian). Tehran; Ketabsara. 1995.
[9]
Radmenesh F, Nejat F. Primary Cerebral Hydatid Cyst: Two Cases Report. Iran J Pediatr 2008; 18(1): 83-6.
[10]
Kovoor JME, Thomas RD, Chandrashekhar HS, Jayakumar PN, Pillai S, Shankar SK. Neurohydatidosis. Australas Radiol 2007; 51(5): 406-11.
[http://dx.doi.org/10.1111/j.1440-1673.2007.01860.x] [PMID: 17803790]
[11]
Anvari M, Amirjamshidi A, Abbassioun K. Gradual and complete delivery of a hydatid cyst of the brain through a single burr hole, a wrong happening! Childs Nerv Syst 2009; 25(12): 1639-42.
[http://dx.doi.org/10.1007/s00381-009-0937-0] [PMID: 19585129]
[12]
Haliloglu M, Saatci I, Akhan O, Ozmen MN, Besim A. Spectrum of imaging findings in pediatric hydatid disease. AJR Am J Roentgenol 1997; 169(6): 1627-31.
[http://dx.doi.org/10.2214/ajr.169.6.9393178] [PMID: 9393178]
[13]
Iyigun O, Uysal S, Sancak R, et al. Multiple organ involvement hydatid cysts in a 2-year-old boy. J Trop Pediatr 2004; 50(6): 374-6.
[http://dx.doi.org/10.1093/tropej/50.6.374] [PMID: 15537728]
[14]
Micheli F, Lehkuniec E, Giannaula R, Caputi E, Paradiso G. Calcified cerebral hydatid cyst. Eur Neurol 1987; 27(1): 1-4.
[http://dx.doi.org/10.1159/000116120] [PMID: 3622570]
[15]
Carrea R, Dowling E Jr, Guevara JA. Surgical treatment of hydatid cysts of the central nervous system in the pediatric age (Dowling’s technique). Childs Brain 1975; 1(1): 4-21.
[http://dx.doi.org/10.1159/000119553] [PMID: 1175437]