Hydatid Cyst In The Brain

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Brain hydatid cyst
Right parieto-occipital cystic lesion next to falx cerebri

Isolated cerebral hydatid cyst is a rare disease. Although hydatid disease primarily involves the liver and lung, it involves the brain in 1-2% of the cases.

The intracranial hydatid cyst can be primary or secondary. The former is when the larva infests the brain directly without involving any other organ. Below is a case of a child with this rare disease.

An 8-year-old, countryside dweller male patient presented to the emergency department with complaints of vomiting after head trauma.

Examination revealed normal neurological examination. Neither did it reveal alteration in any other body function. His doctors performed a computed tomography scan of the head to evaluate the head trauma. CT scan revealed no intracranial hemorrhage; however, it revealed a cystic lesion in the right parieto-occipital region. The cystic lesion was 5 cm in diameter.

Cystic lesion with smooth margins and peripheral enhancement.

Additionally, cranial magnetic resonance imaging revealed a large cystic lesion with peripheral enhancement. Indirect hemagglutination was negative.

The doctors decided to excise the lesion surgically. Hence, they administered 15 mg/kg/d albendazole preoperatively. His surgeons performed a right parieto‑occipital craniotomy, and they excised the lesion.

 The postoperative course remained uneventful, also, the patient made a full recovery.

In the pathological examination, the fibrous wall was excised, and a smooth semi-transparent hydatid cyst was seen. The patient was continued on albendazole.

Semi-transparent hydatid cyst.

At the 2-month follow-up, finally, the cranial MRI revealed no pathological findings.

Brain CT scan 2 months after surgery

Brain Hydatid Cyst:

Clinical manifestations of cranial hydatid cyst include headaches, vomiting, increased intracranial pressure, focal neurological deficits, papilledema, altered mental status, and visual disturbances. Although rare, seizures can also occur. Cerebral hydatid cyst gives characteristic findings on computed tomography scan and magnetic resonance imaging, therefore, these imaging modalities are crucial to reach a diagnosis. Surgery is the treatment of choice with albendazole treatment. However, surgical excision needs precision to avoid intraoperative rupture as it can elicit an anaphylactic reaction. Moreover, it is equally imperative to excise completely to avoid recurrence.

References:

CANAZ G, KILINC B, TOPYALIN N, AKMAN Z, Durmusalioglu I, et al. (2018) Incidentally Diagnosed Asymptomatic Primary Hydatid Cyst of Brain. Clin Med Img Lib 4:084. doi.org/10.23937/2474-3682/1510084

Tuzun Y, Kadioglu HH, Izci Y, Suma S, also Keles M, & Aydin IH: The clinical, radiological, and surgical aspects of cerebral hydatid cysts in children. Pediatr Neurosurg 40:155–160, 2004

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Dr. Arsia Parekh
Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.

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