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Hydatid cyst, which is caused by the cestode echinococcus granulosus, is endemic in many countries around the world. Despite the frequency of this disease, no previous case of cerebral hydatid cyst with orbital extension has been reported, demonstrating the scarcity of this presentation. Cerebral hydatid cyst may be primary or secondary. Given to the nonspecifity of the clinical symptoms, cross sectional imaging, including CT and MRI, play an important role in the diagnosis by ruling out differential diagnoses, which are represented essentially by neoplastic and nonneoplastic intraparenchymal cysts as well as brain abscesses. Surgery remains the cornerstone treatment for cerebral and orbital hydatid cyst. In this article, we present the imaging findings of a patient with a primary cerebral hydatid cyst with orbital extension, and also the radiological features that could eliminate other differential diagnoses.

Background The adult Echinococcus Granulosus resides in the intestines of dogs. Infectious eggs are excreted in the feces. Hydatid infections can affect multiple organs, with the liver being the most commonly involved, followed by the lungs and spleen. Less frequently, the brain, spine, retroperitoneal space, kidneys, and musculoskeletal system can also be affected. Case Presentation A 55-year-old male from a rural area, who owns sheep and dogs, presented with symptoms such as poor coordination in his right hand, agraphia, and acalculia. One week prior to admission, he had a sudden loss of consciousness. CT and MRI scans revealed six distinct cystic lesions in the left parietal lobe, extending towards the lateral ventricle. These lesions were well-defined, non-enhancing, and showed minimal perilesional edema. Whole body CT scan showed no additional cysts. Results After comprehensive investigations, the patient underwent surgery. A left parietal craniotomy was performed, followed by a C-shaped durotomy. Intraoperative ultrasound was utilized to locate the cysts. A minimal corticectomy was made at the posterior border of the parietal lobe. This exposed a cluster of six hydatid cysts located 1 cm subcortically. The cysts were carefully dissected and individually removed using the Dowling-Orlando technique. The remaining cavity was then flushed with a hypersaline solution. The patient recovered well, with no new neurological. He received therapy with albendazole second day after surgical intervention. Histopathological examination confirmed the diagnosis of hydatid cysts. The patient was discharged on the 10th postoperative day. Discussion The Dowling-Orlando technique is a highly effective surgical method for removing cerebral hydatid cysts without causing rupture. Magnification is recommended during the early stages of surgery to avoid damaging the fragile cyst wall and to establish the precise surgical plane. Saline solution is used to dissect the cyst wall from the brain tissue and aid in the removal of the hydatid. Tilting the operation table towards the lesion site and lowering the patient's head assists in the gravity-assisted removal of the cyst.

Hydatid disease is caused by encysted larvae of the dog tapeworm Echinococcus granulosus. Cerebral hydatidosis is a rare central nervous system larval infection affecting approximately 2–3% of patients. CT and MRI scans of the boy, described in our case, showed multiple cystic areas. Total surgical extirpation is the therapeutic approach, emphasizing the importance of early diagnosis for a favourable prognosis. Recurrence and unfavourable outcomes are commonly associated with incomplete excision and surgical rupture, necessitating careful removal to prevent anaphylaxis and widespread infection. Dowling's technique is the preferred surgical approach and postoperatively, patients are administered antiparasitic drugs such as Albendazole or Mebendazole for 6–12 months in most cases, with doses ranging from 10-15mg/kg in divided doses. The results of pharmacological treatment vary across series, with response rates ranging from 43.5 to 80%. Early diagnosis significantly contributes to a favourable prognosis by preventing neurological consequences.

BACKGROUND: The adult Echinococcus Granulosus resides in the intestines of dogs. Infectious eggs are excreted in the feces. Hydatid infections can affect multiple organs, with the liver being the most commonly involved, followed by the lungs and spleen. Less frequently, the brain, spine, retroperitoneal space, kidneys, and musculoskeletal system can also be affected. CASE PRESENTATION: A 55-year-old male from a rural area, who owns sheep and dogs, presented with symptoms such as poor coordination in his right hand, agraphia, and acalculia. One week prior to admission, he had a sudden loss of consciousness. CT and MRI scans revealed six distinct cystic lesions in the left parietal lobe, extending towards the lateral ventricle. These lesions were well-defined, nonenhancing, and showed minimal perilesional edema. Whole body CT scan showed no additional cysts. RESULTS: After comprehensive investigations, the patient underwent surgery. A left parietal craniotomy was performed, followed by a C-shaped durotomy. Intraoperative ultrasound was utilized to locate the cysts. A minimal corticectomy was made at the posterior border of the parietal lobe. This exposed a cluster of six hydatid cysts located 1 cm subcortically. The cysts were carefully dissected and individually removed using the Dowling-Orlando technique. The remaining cavity was then flushed with a hypersaline solution. The patient recovered well, with no new neurological. He received therapy with albendazole second day after surgical intervention. Histopathological examination confirmed the diagnosis of hydatid cysts. The patient was discharged on the 10th postoperative day. DISCUSSION: The Dowling-Orlando technique is a highly effective surgical method for removing cerebral hydatid cysts without causing rupture. Magnification is recommended during the early stages of surgery to avoid damaging the fragile cyst wall and to establish the precise surgical plane. Saline solution is used to dissect the cyst wall from the brain tissue and aid in the removal of the hydatid. Tilting the operation table towards the lesion site and lowering the patient's head assists in the gravity-assisted removal of the cyst. [ABSTRACT FROM AUTHOR]

Hydatid disease is caused by encysted larvae of the dog tapeworm Echinococcus granulosus. Cerebral hydatidosis is a rare central nervous system larval infection affecting approximately 2--3% of patients. CT and MRI scans of the boy, described in our case, showed multiple cystic areas. Total surgical extirpation is the therapeutic approach, emphasizing the importance of early diagnosis for a favourable prognosis. Recurrence and unfavourable outcomes are commonly associated with incomplete excision and surgical rupture, necessitating careful removal to prevent anaphylaxis and widespread infection. Dowling's technique is the preferred surgical approach and postoperatively, patients are administered antiparasitic drugs such as Albendazole or Mebendazole for 6-12 months in most cases, with doses ranging from 10-15mg/kg in divided doses. The results of pharmacological treatment vary across series, with response rates ranging from 43.5 to 80%. Early diagnosis significantly contributes to a favourable prognosis by preventing neurological consequences. [ABSTRACT FROM AUTHOR]

Cystic hydatidosis is a rare zoonotic condition, caused by the larva of the Echinococcus tapeworm. In this disease brain involvement is a rare condition, accounting for about 2-3% of all cases with hydatid disease. Focal deficits, symptoms of increased intracranial pressure, seizure and mental state changes are most common presentations of CNS cystic echinococcosis. We present a young age woman with resistant headache and transient visual obscurations due to increased intra-cranial pressure which caused by Cerebral venous sinus thrombosis (CVST) arising from Hydatid cyst. To the best of our knowledge, this is the first report of hydatid cyst induced CVST. Our case report highlights the importance of considering CVST as an unavoidable complication of brain’s space occupying lesions and especially infective ones as a differential diagnosis.

Hydatid cyst accounts for 3% to 4% of all intracranial lesions. The initial diagnosis is typically based on clinical suspicion, usually with a patient history of having traveled to a region where it is endemic or living in contact with cattle or dogs, and the diagnosis is confirmed with serological tests and imaging. Emergent surgery for cerebral hydatid cyst without first obtaining magnetic resonance image has also been reported in the literature. Presently described is a case of a 22-year-old patient who presented with symptoms of intracranial pressure and neurological deterioration diagnosed as primary cerebral hydatid cyst, and a review of the literature.

Hydatid cysts develop in humans with the transmission of Echinococcus Granulosus or more rarely Echinococcus Multilocularis. The disease develops in the liver 50-75%, and in the lungs 15-35% of the cases. Intracranial hydatid cyst is seen 0.5-3% of the cases. In this case report, we aimed to present the anesthetic approach and possible anaphylactic reaction in a giant primary intracranial hydatid cyst. A five years and eight months old boy (19 kg, 114 cm) was admitted to the emergency room with complaints of a headache, nausea, vomiting, and deviation of the eyes for about 1 month. Fundus examination revealed bilateral disc elevation and severe papillary edema. Cranial magnetic resonance imaging showed a large hydatid cyst in the right parietal lobe. The patient was scheduled for craniotomy by the neurosurgeons. After induction and endotracheal intubation, 1 mg.kg-1 pheniramine hydrogen maleate and 1 mg.kg-1 methylprednisolone were administered as a protective measure against anaphylaxis. The cyst excised by Dowling method, and no rupture observed. The patient, who did not have any perioperative complication, was extubated and followed in the intensive care unit of neurosurgery department. Cerebral hydatid cyst is rare and usually seen in children. This could be explained by the presence of right-to-left shunts. The gold standard in the treatment of cerebral hydatid cysts is surgical removal. In order to prevent recurrence and anaphylactoid reaction, the cyst should be removed without rupturing it. The hemodynamic changes with cyst rupture are seen milder in the patients receiving prophylactic treatment. [Med-Science 2018; 7(2.000): 443-5]

Posterior fossa localization of a hydatid cyst is uncommon; in these cases, the cysts usually grow in the cerebellum. Localization within the subarachnoid spaces or the cerebrospinal fluid ventricular system is exceptional. In the present report, which appears to be the sixth in the literature, we describe a case of a hydatid cyst in the cerebellopontine cistern. Magnetic resonance imaging findings revealed a nonneoplastic cystic lesion mimicking an arachnoid cyst. The hydatid nature of the cyst was unexpected preoperatively. The cyst was successfully removed using the puncture, aspiration, irrigation, and resection technique via a retrosigmoid approach. Histopathologic examination confirmed the cysts to be Echinococcus granulosus in nature. Hydatid cyst may be considered in the differential diagnosis of arachnoid cysts of the cerebellopontine cistern to determine which surgical procedure to perform and to avoid unexpected complications. [ABSTRACT FROM AUTHOR]

Background: Hydatid disease is a life-threatening parasitic infestation caused by Echinococcus granulosus. Infection with E. granulosus typically results in the formation of hydatid cysts in the liver, lungs, kidney, and spleen. Primary intracranial hydatid cyst disease is extremely rare. Here, we are reporting an unusual case of Echinococcus, where the only identifiable lesion was a hydatid cyst in the brain without liver or lung involvement. We are also providing a description for the surgical technique used to remove the cyst, highlighting the possible surgical pitfalls. Case Description: The patient is a 13-year-old male with a history of progressive headache for 1 month. Intracranial hydatid cyst was suspected based on computed tomography and magnetic resonance imaging findings. The cyst was delivered without rupture using hydrostatic dissection (Dowling's technique), and pathological analysis confirmed the diagnosis. Postoperatively, the patient showed marked neurological improvement and all signs and symptoms resolved. Conclusion: Intracranial hydatid cyst is very rare. Nevertheless, it should always be considered as a differential diagnosis in cerebral cystic lesions, especially in children. The surgical technique used to remove the cyst appears to be safe. However, several precautions must be applied intraoperatively to avoid the catastrophe of cyst rupture. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 16-year-old male patient with a six-year history of grand mal epilepsy that became refractory to full doses of phenytoin, phenobarbital, and carbamazepine. It provides an overview of cerebral echinococcosis which represents 2% of all cystic echinococcosis (CE) cases. Details about the use of brain computed tomography (CT) and magnetic resonance imaging (MRI) is presented.

Objective: Brain is involved in 1-2% of hydatid cyst infections. A cranial location is rare. In this study, we aimed to assess clinical findings, radiological investigations, and treatment modalities of cases with intracranial hydatid cyst. Materials and Method: The present study included 26 patients operated for cerebral hydatid cyst disease between January 1990 and October 2012. Results: Seventeen patients were male and 9 were female. The mean age of the study population was 20.3 years (range 7-50 years). Headache and nausea were the most common clinical symptoms. The lesions were demonstrated by computed tomography (CT) and magnetic resonance imaging (MRI) as large, smooth, thin walled, spherical-shaped, cystic homogenous lesions with the same density as cerebro spinal fluid, which showed no edema or contrast uptake. Two patients were complicated or infected cysts with perifocal edema and contrast uptake. In 20 patients, the cysts were removed completely with Dowlings technique, by rectifying cysts without rupturing. Eleven patients with ruptured cysts during operation, recurrent or systemic hydatid cyst were treated medically. Conclusion: Medical therapy appears effective in hydatid cyst disease. Cerebral hydatid cysts should be excised totally without rupturing them. Preoperative imaging techniques are central to surgical planning. Intracranial hydatid cyst should be remembered when CT or MRI shows a cystic lesion, especially in countries where hydatid cyst is endemic. [ABSTRACT FROM AUTHOR]

Background: Hydatid disease is a common infection caused by Echinococcus granulosus. Cerebral involvement is very rare and only occurs in 2% of all hydatidosis in endemic areas. This study reports a case of primary multiple cerebral hydatid cysts in a 23-year- old patient. Case: A 23-year-old female was admitted to the emergency ward with primary generalized tonic colonic seizure, left body and face hemipares, and history of headache in last two months. Contrast enhanced CT and MRI showed a big well-defined, rounded, cystic lesion in the motor strip of right temporo-parietal region with mass effect causing midline shift which was diagnostic for brain hydatid cyst and several smaller cysts. There was no evidence of other organs involvement. The patient underwent brain surgery and a big hydatid cyst (10cm in diameter) and some others adhering to brain parenchyma in different sizes were evacuated completely without rupture using Dowling method. The patient received albendazole 400mg/two times a day for 2 months. There was no cyst in patient's MRI study in the two-year follow up. Conclusion: Though of low incidence, primary multiple cerebral hydatid cysts should be considered in endemic area using brain CT and MRI. Surgery is considered the standard treatment of the disease. [ABSTRACT FROM AUTHOR]

Hydatidosis is an endemic affection in Morocco. Cerebral echinococcosis is a relatively rare entity accounting for only 1-2% of all hydatid cysts in humans. hydatid cyst of the posterior fossa is a very uncommon site for the disease. We report the case of a 12 year-old child admitted for high intracranial pressure. Brain CT scan showed a posterior fossa cyst without enhancement after contrast medium injection. Operative finding revealed a hydatid cyst. The histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole post operatively. He feels well six months later. [ABSTRACT FROM AUTHOR]

Complications related to cerebral hydatid cyst surgery are not uncommon but require prompt diagnosis and treatment. The aim of this study is to demonstrate the radiological findings that would indicate complications after cerebral hydatid cyst surgery in children and to report our results. The data of 25 pediatric patients who underwent surgery for cerebral hydatid cysts over a 16-year period were analyzed retrospectively. The complications related to surgical technique and cyst location were recorded. Postoperative radiological findings of the patients were documented. Intraoperative cyst rupture occured in three patients. Subdural effusion developed in five patients, porencephalic cyst in four, subdural effusion associated with porencephalic cyst in two, hemorrhage in two, epidural hematoma in one, and pneumocephalus in three patients. Subdural-peritoneal shunt was placed in two patients. Recurrence of cerebral hydatid cyst was observed in only one patient who experienced intraoperative cyst rupture. There was no surgery-related death. The complications following cerebral hydatid cyst surgery in children are various and usually not fatal. When appropriate surgical procedures are planned and carefully applied, the results will be excellent with no mortality. [ABSTRACT FROM AUTHOR]

Abstract: A case of 19 years old female patient with 24 large primary cerebral hydatid cysts, in different localisations is presented. Cysts were removed unruptured by five separate operations in 6 months. The patient was observed to be in good health 1 year after the last operation. This case is the first case presented that contains such high number of cysts to our knowledge. The importance of MRI examination in localizing the cysts and designing the operative plan is emphasized. Interestingly, albendazole, which is an antiparasitic drug, was reported to be ineffective by infectious disease department of our hospital, because of large diameter of the cysts, in this case. [Copyright &y& Elsevier]

Abstract: The cerebral localization of the hydatid disease is rare, under 2%, and it primarily affects children. We report 4 cases of children presenting with a cerebral hydatid cyst (2 boys and 2 girls, mean age 9 years). Clinical symptoms were very progressive, the disease was frequently diagnosed several months (1–12 months) after onset of symptoms most often headaches and vomiting. One patient presented with a right tonic-clonic seizure 3 days before hospitalization. The diagnostic was confirmed in all cases by Cerebral CT scan. All the patients were screened for other localizations. One patient also presented with pulmonary and hepatic hydatid cysts. Hydatid blood tests were positive in only one case. The treatment was surgical for all the patients (using hydropulsion) without complications in 2 cases. One child presented with meningitis, and the other child with signs of secondary ICHT related to residual mass which required its puncture. [Copyright &y& Elsevier]

The authors present 27 cases of cerebral hydatid cyst (CHCy) treated between 1980 and 1992. These cases of CHCy represent 2.8% of all cases of expansive nontraumatic lesions in children. Most of the patients were between 6 and 10 years of age. There was a substantial prevalence of male patients - 18 cases (66.6%). Most of the children with CHCy were from rural areas. The cysts were all located in the cerebral hemispheres (none in the posterior fossa). Usually two or three lobes were affected and the cysts were most often retrorolandic. Only 8 patients (29.6%) also had pulmonary or hepatic infestation. All patients were operated on immediately the diagnosis was established. Operative mortality was very low (1 patient died immediately after surgery). There have been 11 cases of recurrence; all these patients have been reoperated on. Neurological sequelae were mainly partial and general seizures. Epilepsy developed postoperatively in five patients. Paresis, which usually disappears in time, was the most common motor disturbance. Two other important postoperative complications were subdural effusion and ventricular dilatation (six cases). There have been five cases of multiple recurrences (four of these patients have since died). Treatment with albendazole was used in three cases without significant results. [ABSTRACT FROM AUTHOR]

Cerebal hydatid cysts account for 2% of all intracranial masses. Preoperative diagnosis is important since cyst rupture and spillage may cause an anaphylactic reaction. CT is the primary modality for the diagnosis. Two forms of cerebral hydatid cysts have been reported on the basis of CT appearances: unilocular and multilocular. Demostration of the cyst wall is important for the diagnosis. MRI is superior to CT for demostrating the cyst capsule and perifocal oedema. We retrospectively reviewed the CT and MRI findings of 6 surgically proven cases of cerebal hydatid cyst and compared the two modalities on the basis of their demonstration of findings helpful in the diagnosis, such as the capsule and perifocal oedema. In 1 case CT showed the capsule. In 2 cases MRI showed a hypointense capsule around the cyst on T2-weighted images. While CT is the modality of choice, in clinical practice MRI is superior for demonstrating the cys capsule, which is a helpful findings in the diagnosis and can be used in inconculsive cases. [ABSTRACT FROM AUTHOR]

Primary multiple cerebral hydatid cysts are extremely rare: In this paper, an 8-year-old male patient who has one primary cerebral hydatid cyst in each cerebral hemisphere is presented. CT findings and operation are discussed. The literature is reviewed and the incidence of multiple cerebral hydatid cyst is compared with the published reports. [ABSTRACT FROM AUTHOR]

Intracranial localization is a rare manifestation of hydatid cyst disease (Echinococcosis). It comprises only 2% of cases of Echinococcosis infection even in endemic areas and is predominantly seen in children. Clinical manifestations resulting from raised intracranial tension are nonspecific. Imaging with computed tomography (CT) may suggest the diagnosis preoperatively with reasonable accuracy. Multidetector-row CT (MDCT) with its high resolution multiplanar reformations can demonstrate the relationship of the cyst with adjacent brain structures and thus help in planning surgery. This has a practical utility in places where magnetic resonance imaging is not available. We describe a case of cerebral hydatid cyst in a 13-year-old boy who was diagnosed with MDCT, which helped in planning its surgical removal. [ABSTRACT FROM AUTHOR]

A 36 years old male patient was complaining about headache, vertigo, balance lost and double sight. On the brain magnetic resonance examination, the multifocal mass lesions were annotated as metastasis. Advanced examination studies done by taking the patient's detailed anamnesis and physical examinations results into consideration was evaluated as hydatic brain metastasis. [ABSTRACT FROM AUTHOR]

Abstract: Hydatidosis is an endemic affection in Tunisia. Cerebral echinococcosis is a relatively rare entity accounting for only 1–2% of all hydatid cysts in humans. Extradural hydatid cyst of the posterior fossa is a very uncommon site for the disease. We report the case of a four-year-old child admitted for high intracranial pressure. Brain CT scan showed an extradural posterior fossa cyst without enhancement after contrast medium injection. Operative finding revealed a hydatid cyst. The histological examination of the tissue sample confirmed the diagnosis. The patient was given albendazole post operatively. She feels well six months later. [Copyright &y& Elsevier]

Abstract: Brain involvement with hydatid disease occurs in 1–2% of all Echinococcus granulosus infections. Cerebral hydatid cysts are usually supratentorial, whereas infratentorial lesions are quite rare. Here we report a 19-year-old man with hydatid cysts in the right cerebellopontine cistern with the involvement of internal acoustic canal and jugular foramen. The patient presented with signs of increased intracranial pressure and multiple cranial nerve palsies. Surgery was performed in the semi-sitting position using a lateral suboccipital approach for a right-sided craniotomy. Magnetic resonance imaging clearly demonstrated cisternal, neural and vascular relationships which aided in intact surgical removal of the lesion using microsurgical techniques. Total removal without rupture should be the surgical goal in all hydatid cysts. [Copyright &y& Elsevier]

Background Hydatid cysts (HCs) are caused by parasites, the larvae of Echinococcus granulosus. They usually affect the liver and lung, but primary brain involvement is rarely seen. HCs may cause a mass effect in the brain. For this reason, surgical excision must be performed. Complications may rarely occur after surgery. Recognition of complications is of vital importance. Case Description A 45-year-old man presented with complaints of personality disorder and severe, long-standing headache. The patient had no neurologic deficit. However, there were symptoms associated with increased intracranial pressure. Radiologic examination revealed intracranial HCs. Complications did not develop during the operation. Six months following the surgery, the patient came back after experiencing unconsciousness. Control cerebral magnetic resonance imaging showed multiple cerebral cysts. Conclusions Surgical resection should be applied carefully in the treatment of cerebral cysts. Complications may occur later in patients who do not develop complications at the time of operation. For this reason, follow-up of the patients should definitely be done by magnetic resonance imaging. Highlights • Primary brain involvement of hydatid cyst (HC) is uncommon. • Hydatidosis following surgery in these patients is an unexpected finding. • Cerebral magnetic resonance imaging shows multiple cerebral cysts associated with hydatidosis. [ABSTRACT FROM AUTHOR]

The CT features of cerebral hydatid cysts are divided into two groups. In the unilocular cases, the cyst is large, spherical in shape with sharply defined borders. One side of the cyst wall is very close to the calvarium. The cyst may calcify and may have septae inside. There is no enhancement with contrast media and also no edema surrounding the cyst. In the second group there are multiple and small multilocular cysts. These cysts are in ovoid or polygonal forms like a bunch of grapes, with perifocal edema. After contrast media administration, there is enhancement in the cyst wall. In one case there were numerous cysts in both hemispheres. [ABSTRACT FROM AUTHOR]

The case of a 9-year-old-boy with a left frontal hydatid cyst is reported. The infection was transmitted by a dog, the final host and a companion of the child. Recovery without complications was accomplished after puncturing, systemic antihelminthic therapy using mebendazole and, finally, total removal of the cyst. [ABSTRACT FROM AUTHOR]

Multiple intracranial hydatid cysts are uncommon and usually localized in the supratentorial compartment. We report a case studied by CT and MR of multiple intracranial hydatid cysts scattered in various anatomic sites: supratentorial, infratentorial and also intraventricular. [ABSTRACT FROM AUTHOR]