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Ahmed M, Basurrah AA, Brinji ZS, Albargi N, EL-Fattah MA, Alnashiwaaty O, Aljohani MS, Alkhotani A, Farag AA. A case report of an unusual cerebral hydatid cyst. Surg Neurol Int 2024; 15:99. [PMID: 38628511 PMCID: PMC11021106 DOI: 10.25259/sni_70_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/28/2024] [Indexed: 04/19/2024] Open
Abstract
Background Intracranial hydatid cyst is an exceedingly uncommon condition. Typically, it manifests as hydatid cysts in the liver, lungs, kidney, and spleen. In this report, we present a rare case of a hydatid cyst located in the brain, exhibiting atypical radiological characteristics, and successfully treated with complete microsurgical excision. Case Description A 45-year-old male, a former smoker, presented with a new-onset seizure. Brain imaging revealed a solitary, intra-axial, and cystic lesion with wall enhancement in the right temporal region. The cyst extended into the temporal horn of the right lateral ventricle, surrounded by mild edema. Differential diagnoses included brain metastasis, abscess, and tuberculoma. However, following computed tomography (CT) scans of the chest, abdomen, and pelvis (CAP) and serological tests, the provisional diagnosis included a hydatid cyst. The CT CAP showed diffuse non-specific cystic lesions of variable sizes in the liver and spleen, along with numerous bilateral pulmonary cysts. A right temporal craniotomy was performed, and the cyst was microsurgically excised without rupture. Microscopic and histopathological examination confirmed the presence of a hydatid cyst. Conclusion Intracranial hydatid cyst is an extremely rare condition and should always be considered a possible differential diagnosis in cases of cerebral cystic lesions. Hydrodissection is the preferred surgical method for resection; however, in atypical cases such as the one described here, meticulous dissection of the cyst capsule from the brain parenchyma may be successful with minimal risk of intraoperative rupture.
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Affiliation(s)
- Mubasher Ahmed
- Department of Neurosurgery, King Abdullah Medical City, Makkah, Saudi Arabia
| | | | - Zaina Siraj Brinji
- Department of Radiology, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Naseem Albargi
- Department of Radiology, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Mona Abd EL-Fattah
- Department of Medical Laboratory Administration/Microbiology Parasitology, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Omar Alnashiwaaty
- Department of Infectious Disease, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Mona Shadad Aljohani
- Department of Infectious Disease, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Alaa Alkhotani
- Department of Pathology, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ahmed Adel Farag
- Department of Neurosurgery, King Abdullah Medical City, Makkah, Saudi Arabia
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2
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Arega G, Merga G, Tafa G, Salah FO, Abebe G, Maru S, Ergete W. Temporoparietal Brain Hydatid Cyst in an Eight-Year-Old Child: A Rare Case Report. Pediatric Health Med Ther 2022; 13:361-365. [DOI: 10.2147/phmt.s390336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
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3
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Samadian M, Mousavinejad SA, Jabbari A, Tavassol HH, Karimi P, Almagro K, Rezaei O, Borghei-Razavi H. Third ventricle hydatid cyst: A rare case report and review of the literature. Clin Neurol Neurosurg 2020; 198:106218. [PMID: 32932026 DOI: 10.1016/j.clineuro.2020.106218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 11/19/2022]
Abstract
A primary intraventricular hydatid cyst is a very rare phenomenon, which is mostly located in the lateral ventricle. To the best of our knowledge, only two cases of third ventricle hydatid cyst have been reported. Herein, we present a very rare case of third ventricle hydatid cyst in a four- year-old boy with nausea, vomiting, and progressive drowsiness. Neuroradiological examination revealed a large, spherical, well-defined cystic lesion within the third ventricle. The patient underwent surgery using the anterior interhemispheric transcallosal approach, and the cyst was successfully removed using the Dowling's technique. In this case report, we described the first case of transcallosal removal of a rare third ventricle hydatid cyst, which can be considered in the differential diagnosis of suprasellar arachnoid cysts. Caution must be taken in determining the best surgical approach to prevent unexpected complications.
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Affiliation(s)
- Mohammad Samadian
- Departments of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Mousavinejad
- Departments of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ahmad Jabbari
- Departments of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hesameddin Hoseini Tavassol
- Departments of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Kristen Almagro
- Department of Neurosurgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida, USA
| | - Omidvar Rezaei
- Departments of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Borghei-Razavi
- Department of Neurosurgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, Florida, USA
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4
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Gök H, Başkurt O. Giant Primary Intracranial Hydatid Cyst in Child with Hemiparesis. World Neurosurg 2019; 129:404-406. [PMID: 31254691 DOI: 10.1016/j.wneu.2019.06.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
Abstract
Hydatid cyst is the larval form of the parasite Echinococcus. Echinococcus granulosus and less commonly Echinococcus multilocularis species cause the disease. Intracranial hydatid disease is relatively rare; the incidence is approximately 1%-2%. Intracranial hydatid cyst can be classified as primary and secondary. A primary cyst, the most common type, is always solitary. The treatment of hydatid cyst is surgical, and the aim of surgery is to remove the cyst without rupture to prevent recurrence or anaphylactic reaction. The Dowling technique (improved by Arana-Iniguez and San Julian) has been widely used for the excision. Albendazole and praziquantel are the medical treatment of choice. In recurrent cases or cases with rupture during surgery, medical therapy has been reported to be effective. Preoperative and postoperative albendazole may be considered to sterilize the cyst, decrease the chance of anaphylaxis, lower the tension in the cyst wall, and reduce the recurrence.
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Affiliation(s)
- Haydar Gök
- Department of Neurological Surgery, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Ozan Başkurt
- Department of Neurological Surgery, Okmeydani Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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5
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Pandey S, Pandey D, Shende N, Sahu A, Sharma V. Cerebral intraventricular echinococcosis in an adult. Surg Neurol Int 2015; 6:138. [PMID: 26392915 PMCID: PMC4553664 DOI: 10.4103/2152-7806.163177] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 05/31/2015] [Indexed: 11/29/2022] Open
Abstract
Background: Echinococcosis in humans occurs as a result of infection by the larval stages of taeniid cestodes of the genus echinococcus. Intracranial hydatid cysts usually develop at an intraparenchymal site. Hydatid cyst within the cerebral ventricle is quite unusual. Methods: We reviewed the literature on adult intraventricular hydatid cyst and found case reports mainly in children with an only handful of cases in adults. We reported a rare case of cerebral intraventricular (left lateral ventricle) hydatid cyst in a 21-year-old adult female. Results: Although cerebral hydatid cysts are most commonly seen in children and young adults cerebral intraventricular hydatid cyst are comparatively rarer in adults. Conclusion: The possibility of infection with Echinococcus granulosus should be included in the differential diagnosis of raised intracranial hypertension in patients from endemic areas.
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Affiliation(s)
- Sharad Pandey
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Deepa Pandey
- Department Clinical Microbiology, DLW, Varanasi, Uttar Pradesh, India
| | - Neeraj Shende
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Anurag Sahu
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Vivek Sharma
- Department of Neurosurgery, Sir Sunderlal Hospital, IMS, BHU, Varanasi, Uttar Pradesh, India
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6
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Senapati SB, Parida DK, Pattajoshi AS, Gouda AK, Patnaik A. Primary hydatid cyst of brain: Two cases report. Asian J Neurosurg 2015; 10:175-6. [PMID: 25972961 PMCID: PMC4421967 DOI: 10.4103/1793-5482.152109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Brain involvement with hydatid disease occurs in 1–2% of all Echinococcus granulosus infections. Isolated cerebral hydatid disease is a rare manifestation of it. In this report, we analyze two cases of isolated cerebral hydatid cysts and discuss their mode of presentation, radiological features, operative procedure and outcome. In our two cases, radiological features and surgical approaches were different from one another. The literature concerning isolated cerebral hydatid disease is reviewed.
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Affiliation(s)
- Satya Bhusan Senapati
- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - Deepak Kumar Parida
- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - A S Pattajoshi
- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - Amiya Kumar Gouda
- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
| | - Ashis Patnaik
- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
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7
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Duransoy YK, Mete M, Barutçuoğlu M, Unsal UÜ, Selçuki M. Intracranial hydatid cyst is a rare cause of midbrain herniation: A case report and literature review. J Pediatr Neurosci 2014; 8:224-7. [PMID: 24470819 PMCID: PMC3888042 DOI: 10.4103/1817-1745.123683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hydatid disease is a parasitic infection affecting the brain in about 2% of the cases. Brain involvement is most commonly observed in children. Here, we report a 13-year-old male patient who presented with headache, nausea, and vomiting. Before cranial computed tomography (CT) was performed, the patient had generalized epileptic seizures. He was disoriented, and had anisocoria with dilatation of the right pupilla. CT showed a cystic lesion of 10-cm diameter in the right temporoparietal region that had caused a shift of the midline structures to the contralateral side; an urgent operation was performed as there were signs of midbrain herniation.
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Affiliation(s)
| | - Mesut Mete
- Department of Neurosurgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Mustafa Barutçuoğlu
- Department of Neurosurgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Ulkün Ünlü Unsal
- Department of Neurosurgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Mehmet Selçuki
- Department of Neurosurgery, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
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8
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Vidhate MR, Singh D, Sharma P, Singh MK. Cerebral hydatid cyst showing pathognomonic daughter cysts. Ann Indian Acad Neurol 2011; 14:217-8. [PMID: 22028541 PMCID: PMC3200051 DOI: 10.4103/0972-2327.85903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/09/2011] [Accepted: 03/31/2011] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mukund R Vidhate
- Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India
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9
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Cranial epidural hydatid cysts: clinical report and review of the literature. Acta Neurochir (Wien) 2009; 151:659-62. [PMID: 19319472 DOI: 10.1007/s00701-009-0276-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2008] [Accepted: 03/10/2009] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cerebral hydatidosis accounts for approximately 1-3% of all cases of hydatid disease. METHOD In this report, 32-year-old female with epidural multilocular hydatid cysts in the midline posterior parietal region is reported. FINDINGS Most commonly, cerebral hydatid cysts are single lesions and locate in the watershed of the middle cerebral artery. CONCLUSIONS However, cerebral epidural hydatid cysts seem to have a tendency occurring around in the highly vascularized venous sinus.
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10
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Stamatakos M, Sargedi C, Stefanaki C, Safioleas C, Matthaiopoulou I, Safioleas M. Anthelminthic treatment: an adjuvant therapeutic strategy against Echinococcus granulosus. Parasitol Int 2009; 58:115-20. [PMID: 19272345 DOI: 10.1016/j.parint.2009.01.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 12/30/2008] [Accepted: 01/07/2009] [Indexed: 11/17/2022]
Abstract
The main goal of the paper is to clarify anthelminthic treatment as an alternative hydatic cyst therapy, its indications and contraindications. Chemotherapy constitutes a non-invasive treatment and is less limited by the patient's status than surgery or PAIR. Many investigators have employed benzoimidazole carbonates for the management of human hydatid disease. Both, albendazole and mebendazole have, a favourable effect in patients suffering from multiorgan and multicystic disease, in inoperable primary liver or lung echinococcosis, and they can also prevent secondary echinococcosis. Chemotherapy is contraindicated for large cysts that are at risk to rupture and for inactive or calcified cysts. The main adverse events are related to changes in liver enzyme levels. The best efficacy is observed with liver, lung, and peritoneal cysts. Certain various factors influence the therapeutic results of medical treatment. The vast majority of the recurring cysts show good susceptibility to re-treatment.
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Affiliation(s)
- M Stamatakos
- 2nd Propaedeutic Department of Surgery, Medical School, University of Athens, Laiko General Hospital, Athens, Greece.
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11
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Kayaoglu CR. Giant Hydatid Cyst in the Posterior Fossa of a Child: A Case Report. J Int Med Res 2008; 36:198-202. [PMID: 18230279 DOI: 10.1177/147323000803600125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 10-year-old boy was admitted with a 4-month history of ataxic gait, headache, vomiting and diplopia. The headaches had worsened in month 4 and were associated with vomiting during head movement. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) scans revealed a hydatid cyst located in the posterior fossa. The patient underwent suboccipital craniotomy and a cerebellar hydatid cyst (approximately 5 cm in diameter) was removed using Dowling's technique. The diagnosis was confirmed during surgery and by histological examination of a tissue sample from the cyst. The patient was treated with the antihelmintic agent albendazole in combination with antibiotics. The postoperative course was uneventful and the patient was discharged after 1 week. In conclusion, when a cystic lesion is detected on CT or MRI scans, hydatid disease should be taken into consideration in countries where hydatid infestation is endemic.
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Affiliation(s)
- CR Kayaoglu
- Department of Neurosurgery, Medical School, Ataturk University, Erzurum, Turkey
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12
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Tlili-Graiess K, El-Ouni F, Gharbi-Jemni H, Arifa N, Moulahi H, Mrad-Dali K, Guesmi H, Abroug S, Yacoub M, Krifa H. [Cerebral hydatid disease: imaging features]. J Neuroradiol 2007; 33:304-18. [PMID: 17213758 DOI: 10.1016/s0150-9861(06)77288-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cerebral hytatid cysts (HC) are extremely rare, forming 2% of all intra cranial space occupying lesions even in counties where the disease is endemic. HC diagnosis is usually based on a pathognomonic computed tomography (CT) pattern. In order to assess the value of MR we reviewed the CT (n=25) and magnetic resonance (MR, n=4 including diffusion and proton magnetic resonance spectroscopy in 1) imaging of 25 patients with pathologically confirmed cerebral hydatid disease. 19 HC were seen in children under 16 years. All were supra tentorial with 22 in the middle cerebral artery territory. HC was solitary in 18 cases, unilocular in 23 and multi-vesicular in 2 with heavily calcified pericyst in 1. 2 cysts were intra ventricular and 1 intra aqueducal. The most typical features were well defined, smooth thin walled spherical or oval cystic lesions of CSF density and/or signal with considerable mass effect (20/25). Surrounding oedema with complete or incomplete rim enhancement was seen in 3 cases which were labelled as complicated and/or infected cysts. Although CT is diagnostic of hydatid disease in almost all cases (22/25), MRI including diffusion and spectroscopy precisely demonstrate location, number, cyst capsule, type of signal and enhancement and allows diagnosis of atypical or complicated HC and appears more helpful in surgical planning.
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13
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Turkoglu OF, Solaroglu I, Tun K, Beskonakli E, Taskin Y. Secondary infection of intracranial hydatid cyst with Clostridium ramosum. Childs Nerv Syst 2005; 21:1004-7. [PMID: 15580512 DOI: 10.1007/s00381-004-1061-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2004] [Revised: 07/06/2004] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Brain involvement in hydatid disease occurs in 1-2% of all Echinococcus granulosus infections. Secondary infection of intracranial hydatid cysts is extremely rare. CASE REPORT AND DISCUSSION In this case report, we present a secondary infection of an intracranial hydatid cyst due to Clostridium ramosum, which is an extremely rare infectious pathogen in neurosurgical practice, and a potential pitfall in neuroradiological investigations.
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Affiliation(s)
- Omer Faruk Turkoglu
- Department of Neurosurgery, Ankara Numune Research and Education Hospital, Turkey.
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14
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Kiresi DA, Karabacakoglu A, Odev K, Karakose S. Pictorial Review. Uncommon Locations of Hydatid Cysts. Acta Radiol 2003. [DOI: 10.1046/j.1600-0455.2003.00135.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Cheshire WP, Santos CC, Massey EW, Howard JF. Spinal cord infarction: etiology and outcome. Neurology 1996; 47:321-30. [PMID: 8757000 DOI: 10.1212/wnl.47.2.321] [Citation(s) in RCA: 270] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
We reviewed 44 cases of ischemia and infarction of the spinal cord at two university hospitals. Three patients experienced transient ischemic attacks. Etiologies of completed strokes were diverse and included rupture and surgical repair of aortic aneurysms, aortic dissection, aortic rupture and thrombosis, global ischemia, anterior spinal artery embolism, repair and thrombosis of spinal arteriovenous malformations, hematomyelia, epidural hematoma, cervical osteophytosis, celiac plexus block, systemic lupus erythematosus, coagulopathy, and decompression sickness. Motor function improved in 12 patients, was substantial in only one, and occurred largely within the first 2 to 4 weeks. Favorable ambulatory outcome correlated with improving neurologic examinations and relatively preserved strength in hip abductors and knee extensors. More extensive deficits without initial improvement portended a more severe prognosis. Autonomic dysfunction, pain, paresthesia, and depression were common and impeded recovery in some patients. The mean level of deficit was at T-8 and in cases of global ischemia was at T-9, which leads us to dispute the classical view of a midthoracic watershed zone of ischemic vulnerability near T-4.
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Affiliation(s)
- W P Cheshire
- Department of Neurology, University of North Carolina, Chapel Hill, USA
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