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Ghasemi AA, Mohammadzade H, Mohammadi R. Giant hydatid cyst of the brain: Intact cyst removal in 8-year-old child. Int J Surg Case Rep 2023; 106:108172. [PMID: 37086506 PMCID: PMC10154730 DOI: 10.1016/j.ijscr.2023.108172] [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: 02/07/2023] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Cystic echinococcosis (hydatidosis) in humans is an infectious disease caused by tapeworms of Echinococcus genus. Brain involvement is rare. The best treatment is surgery and intact cyst removal is mandatory to prevent recurrence and possible anaphylactic reaction. CASE PRESENTATION An 8-year-old girl presented with a 1-month history of malaise, headache and vomiting. On Physical examinations, she was disoriented with bilateral papilledema. Brain CT scan and MRI revealed a well-defined cystic mass in left temporo-parieto-occipital region with considerable midline shift without perilesional edema. The patient was diagnosed with brain hydatid cyst and underwent surgical excision of the cyst without rupture. CLINICAL DISCUSSION Surgery is the most important part of intracranial hydatid cyst treatment, and surgeons should make every effort to remove them in toto without spillage. We hence decided to perform surgery and necessary precautions to prevent rupture and dissemination of hydatid were taken during the surgery. CONCLUSION A neurosurgeon has to bear in mind brain hydatid cyst in the differential diagnosis of cystic cerebral lesions especially in children from rural areas. The hydrodissection technique is the gold standard for the surgical treatment of cerebral hydatid cyst disease. It can also be effectively applied to the treatment of giant cerebral hydatid cyst disease without rupturing the cyst.
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Affiliation(s)
- Amir Abbas Ghasemi
- Urmia University of Medical Sciences, Ershad BLVD, Imam Khomeini Hospital, Urmia, Iran.
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2
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Khalili N, Iranpour P, Khalili N, Haseli S. Hydatid Disease: A Pictorial Review of Uncommon Locations. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:118-129. [PMID: 36895460 PMCID: PMC9989246 DOI: 10.30476/ijms.2022.93123.2442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 03/11/2023]
Abstract
Hydatid disease is a zoonotic infection caused primarily by the tapeworm parasite, Echinococcus granulosus. It is considered an endemic disease in the Mediterranean region. In about 90% of cases, hydatid cysts are found in the liver and lungs; however, any other organ in the body may be affected, particularly in endemic areas. When encountering cystic lesions in these areas, the physician should always keep hydatid disease as a possible diagnosis in mind. To avoid life-threatening conditions such as anaphylactic shock or pressure effect on vital organs, timely diagnosis, and proper management are critical. When a rare site is involved, hydatid disease should be diagnosed using a combination of serologic assays and imaging modalities such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). These imaging modalities can also be used to determine the extent of the disease and assess possible complications. Here, we present a pictorial review of typical imaging manifestations of hydatid cysts in unusual sites. Being aware of these imaging features will assist physicians in making an accurate, timely diagnosis and subsequently, providing optimal management.
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Affiliation(s)
- Nastaran Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Pooya Iranpour
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Sara Haseli
- Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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3
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Maamri K, Cherif I, Trifa A, Nessib N, Elkahla G, Darmoul M. Hydatid cyst in the third ventricle of the brain: case report of an exceptionally rare condition. Childs Nerv Syst 2022; 38:1637-1641. [PMID: 35137268 DOI: 10.1007/s00381-022-05460-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/17/2022] [Indexed: 12/13/2022]
Abstract
Hydatid disease is an endemic zoonotic disease caused by the cestode Echinococcus multilocularis and Echinococcus granulosus. Intra-ventricular hydatid cysts are extremely rare. Even more rarely, and to the best of our knowledge, only three cases of third ventricle involvement have been reported. Herein, we present the fourth case of an intraventricular hydatid cyst in a pediatric patient located in the third ventricle. It is about a 7-year-old girl, of a rural origin, admitted for intracranial hypertension, deterioration of the general status, and weakness on the right side of her body. A cerebral magnetic resonance imaging (MRI) showed the presence of a rounded cystic formation in the third ventricle. The patient was operated through a transfrontal transventricular approach, and the cyst was removed. Postoperative course was uneventful. Hydatid disease should be considered part of the differential diagnosis for cystic lesions of the central nervous system, especially in endemic regions. Total removal of the cysts without rupture is a challenge, but best treatment remains an active nationwide prevention.
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Affiliation(s)
- Kais Maamri
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia.
| | - Ines Cherif
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Amine Trifa
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Nessrine Nessib
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Ghassen Elkahla
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
| | - Mehdi Darmoul
- Neurosurgery Department, Fattouma Bourguiba University Hospital, Rue Farhat Hached, 5000, Monastir, Tunisia
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4
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Uzunoglu H, Gul MO. A Case Report of Liver and Pancreatic Echinococcal Cysts. Niger J Clin Pract 2022; 25:114-117. [PMID: 35046205 DOI: 10.4103/njcp.njcp_500_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 54-year-old female patient with complaints of abdominal pain for 2 months was admitted to the General Surgery clinic of our tertiary care hospital. Abdominal ultrasound (US) and computed tomography revealed cholelithiasis, liver hydatid cyst, and hypodense multicystic mass lesion in the pancreatic body. In the endoscopic US performed, pancreatic hydatid cysts were considered as the pre-diagnosis. Cystotomy and external drainage were performed on the 8-cm cystic lesion in the pancreas head-class junction. Pancreatic hydatid cyst can be rarely seen isolated or can develop synchronously to liver hydatid cyst, and should be kept in mind in a differential diagnosis. If the perioperative diagnosis is confirmed and in case of the absence of a pancreatic ductal fistula, surgical morbidity and mortality can be reduced by applying cystotomy and external drainage procedures.
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Affiliation(s)
- H Uzunoglu
- Department of General Surgery, Kartal Dr Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - M O Gul
- Department of Surgical Oncology, Cukurova University, Balcali Hospital, Adana, Turkey
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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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Cerebral Cystic Echinococcosis. Case Rep Infect Dis 2020; 2020:1754231. [PMID: 32181029 PMCID: PMC7066420 DOI: 10.1155/2020/1754231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 02/08/2020] [Indexed: 11/17/2022] Open
Abstract
Cystic echinococcosis (CE) is a neglected helminthic disease and major public health problem in several regions of the world. The zoonosis is caused by the larval stage of different cestode species belonging to the genus Echinococcus. CE can affect any organ with the liver and lungs being most commonly involved. The brain is involved in less than 2% of the cases. We report a case of a CE1 echinococcal cyst of the brain in an Iranian patient.
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Fadel SA, Asmar K, Faraj W, Khalife M, Haddad M, El-Merhi F. Clinical review of liver hydatid disease and its unusual presentations in developing countries. Abdom Radiol (NY) 2019; 44:1331-1339. [PMID: 30306203 DOI: 10.1007/s00261-018-1794-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Human hydatid cyst disease is an international public health issue that particularly affects the developing countries. In this article, we discuss the epidemiology of hydatid disease in third world countries, the life cycle of echinococcus granulosus and how to make the clinical diagnosis of the disease, including laboratory tests and imaging modalities as well as uncommon presentation of this entity that we have encountered at the American University of Beirut Medical Center (AUBMC). We emphasize on the new World Health Organization classification of hepatic echinococcosis with examples from our clinical practice at AUBMC, and finally we describe the treatment, including medical and interventional therapies.
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Affiliation(s)
- Sandra Abi Fadel
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Karl Asmar
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Walid Faraj
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohammad Khalife
- Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maurice Haddad
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi El-Merhi
- Diagnostic Radiology Department, American University of Beirut Medical Center, Riad El Solh, PO Box 11-0236, Beirut, 1107 2020, Lebanon.
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Demir MK, Yapıcıer O, Hasanov T, Yılmaz B, Kılıç T. Hydatid disease: MR imaging of calvarium and superior sagittal sinus involvement. Neuroradiol J 2018. [PMID: 29532712 DOI: 10.1177/1971400918764130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Extra-axial hydatid disease (HD) is rare and may create a diagnostic challenge. Herein, we report an extremely rare case of calvarial HD with superior sagittal sinus invasion and an extension to the scalp with unusual magnetic resonance imaging findings simulating osteomyelitis and abscess. Recognition of detached endocystic membranes was the most important clue for the correct diagnosis. HD should be included in the differential diagnosis for a patient having a destructive skull lesion with peripheral enhancing extra-axial soft tissue component. Preoperative correct imaging diagnosis is crucial to improving patient management.
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Affiliation(s)
- Mustafa Kemal Demir
- 1 Department of Radiology, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, Istanbul, Turkey
| | - Ozlem Yapıcıer
- 2 Department of Pathology, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, Istanbul, Turkey
| | - Teyyub Hasanov
- 3 Department of Neurosurgery, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, Istanbul, Turkey
| | - Baran Yılmaz
- 3 Department of Neurosurgery, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, Istanbul, Turkey
| | - Türker Kılıç
- 3 Department of Neurosurgery, Bahçeşehir University School of Medicine, Göztepe Medical Park Hospital, Istanbul, Turkey
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El Saqui A, Aggouri M, Benzagmout M, Chakour K, El Faiz Chaoui M. [Cerebral hydatid cysts in children: about 15 cases]. Pan Afr Med J 2017; 26:205. [PMID: 28690720 PMCID: PMC5491731 DOI: 10.11604/pamj.2017.26.205.8398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/05/2016] [Indexed: 11/23/2022] Open
Abstract
L’objectif de notre étude est d’illustrer l’intérêt de l’imagerie en coupe (TDM, IRM) dans le diagnostic positif et le suivi post-thérapeutique du kyste hydatique cérébral chez l’enfant et de mettre en lumière les particularités et les difficultés rencontrées dans la prise en charge de la localisation cérébrale de cette affection, par notre expérience basée sur 15 cas de kyste hydatique cérébral de l’enfant. Il s’agit d’une étude rétrospective de 15 cas d’hydatidose cérébrale de l’enfant colligés sur une période de 10 ans. La TDM cérébrale en coupes axiales de 5 mm d’épaisseur sans et avec injection de produit de contraste a été réalisée chez 15 patients. L’IRM encéphalique a été réalisée en séquences pondérées en T1 et en T2 chez un patient dans les trois plans de l’espace sans injection de Gadolinium. L’âge moyen de nos patients était de 9 ans. La symptomatologie clinique était dominée par le syndrome d’hypertension intracrânienne. Le kyste hydatique était solitaire et se situait au niveau de l’étage sus-tentoriel avec un important effet de masse sur le système ventriculaire et la ligne médiane dans la majorité des cas. Tous nos patients ont été opérés et l’évolution était favorable dans tous les cas. La TDM représente l’examen de choix pour le diagnostic et le suivi postopératoire du kyste hydatique cérébral. L’IRM trouve son intérêt essentiellement dans le diagnostic des formes multiples et des formes atypiques permettant une planification thérapeutique plus adaptée. Our study aimed to highlight the role of cross sectional imaging techniques (CT, MRI) in positive diagnosis and post-therapeutic follow-up of cerebral hydatid cysts in children as well as to describe the peculiarities and the difficulties encountered in the management of these cysts based on our experience about 15 cases. We conducted a retrospective study of 15 cases of cerebral hydatidosis in children whose data were collected over a period of 10 years. CT scan of the brain with 5 mm slice thickness without and with injection of contrast product was performed in 15 patients. One patient underwent brain MRI creating either T1-weighted or T2-weighted images in all three planes without Gadolinium injection. The average age of patients was 9 years. Clinical symptoms were dominated by intracranial hypertension syndrome. Hydatid cyst was solitary and was located in the supratentorial level with an important mass effect on the ventricular system and the median line in most cases. All patients underwent surgery and patients’ evolution was favorable in all cases. CT scan is the test of choice for the diagnosis and the postoperative follow-up of patients with cerebral hydatid cysts. MRI is used essentially in the diagnosis of multiple and atypical type of cerebral hydatid cysts, enabling the design of more effective treatment strategy.
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10
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Mao R, Zhang WB, Qi HZ, Jiang T, Wu G, Lu PF, Ainiwaer A, Shang G, Xu L, Hao J, Shou X, Li HT, Li J, Zhang SA, Bao YX, Wen H. Efficacy of radiotherapy for the treatment of cystic echinococcosis in naturally infected sheep. Infect Dis Poverty 2017; 6:88. [PMID: 28464914 PMCID: PMC5414231 DOI: 10.1186/s40249-017-0301-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 04/05/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Radiotherapy is commonly used to treat cancers. To date, there has been no study focusing on the effects of radiotherapy on hydatid disease in large animals. In this study, we aim to investigate the efficiency and safety of radiotherapy for treating hydatid disease caused by Echinococcus granulosus in naturally infected sheep. METHODS Ultrasound was used to screen naturally infected sheep in an echinococcosis endemic area in Xinjiang, China. A computer tomography (CT) scan confirmed the presence of hydatid cysts. Twenty sheep naturally infected with E. granulosus in the liver and/or lungs were randomly assigned into four groups receiving no irradiation, or X-ray irradiation of low (30 Gy), medium (45 Gy), and high dose (60 Gy), respectively. After three months of radiotherapy, a CT scan was performed to measure the changes in the cysts. The hepatic parasite cysts and host tissues were collected for histology and gene expression analysis. RESULTS In the animals subject to irradiation, no significant differences were observed in their appetite, daily activities, and weight before and after radiotherapy. Severe calcification was noticed in the cysts subject to a high dose of radiation compared with the groups subject to low and medium doses. Hematoxylin and eosin staining showed that irradiation contributed to the damage of the cyst structure and nucleus in the germinal layers. Quantitative PCR demonstrated that expression of TPX and HSP70 significantly decreased in a dose-dependent manner (P < 0.05). The expression of the EPC1 decreased in the medium- and high-dose groups compared with the low-dose group (P < 0.05). Meanwhile, the expression of radiation-related apoptosis genes caspase-3 and Gadd45 decreased with an increase in the irradiation dose. CONCLUSIONS Radiotherapy is an option with satisfactory efficiency and safety for treating cystic echinococcosis in sheep with partial response or stable disease at month 3. In future, inhibition of cystic activity using radiotherapy may serve as a new regimen for treating hydatid disease.
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Affiliation(s)
- Rui Mao
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Wen-Bao Zhang
- State Key Laboratory Incubation Base for Xinjiang Major Diseases Research and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Hong-Zhi Qi
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Tao Jiang
- State Key Laboratory Incubation Base for Xinjiang Major Diseases Research and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Ge Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Peng-Fei Lu
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Abudula Ainiwaer
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Ge Shang
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Lin Xu
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Jie Hao
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Xi Shou
- State Key Laboratory Incubation Base for Xinjiang Major Diseases Research and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Hai-Tao Li
- State Key Laboratory Incubation Base for Xinjiang Major Diseases Research and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Jun Li
- State Key Laboratory Incubation Base for Xinjiang Major Diseases Research and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Song-An Zhang
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China
| | - Yong-Xing Bao
- Department of Radiation Oncology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China.
| | - Hao Wen
- State Key Laboratory Incubation Base for Xinjiang Major Diseases Research and Xinjiang Key Laboratory of Echinococcosis, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China.
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Zalaquett E, Menias C, Garrido F, Vargas M, Olivares JF, Campos D, Pinochet N, Luna A, Dahiya N, Huete Á. Imaging of Hydatid Disease with a Focus on Extrahepatic Involvement. Radiographics 2017; 37:901-923. [DOI: 10.1148/rg.2017160172] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Eugenio Zalaquett
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Christine Menias
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Francisco Garrido
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Matías Vargas
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - José Francisco Olivares
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Daniel Campos
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Natalia Pinochet
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Antonio Luna
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Nirvikar Dahiya
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
| | - Álvaro Huete
- From the Department of Radiology, Complejo Asistencial Doctor Sótero del Río, Santiago, Chile (E.Z.); Department of Radiology, Mayo Clinic, Scottsdale, Ariz (C.M., N.D.); Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd Floor, Santiago 8330024, Chile (F.G., M.V., J.F.O., D.C., N.P., A.H.); and Health Time, Jaén, Spain (A.L.)
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Altibi AMA, Qarajeh RAH, Belsuzarri TAB, Maani W, Kanaan TMA. Primary cerebral echinoccocosis in a child: Case report - Surgical technique, technical pitfalls, and video atlas. Surg Neurol Int 2016; 7:S893-S898. [PMID: 27999716 PMCID: PMC5154201 DOI: 10.4103/2152-7806.194512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 10/21/2016] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Telmo A B Belsuzarri
- Department of Neurosurgery, Pontifical Catholic University of Campinas (PUC-CAMPINAS), São Paulo, Brazil
| | - Walid Maani
- Faculty of Medicine, University of Jordan, Jordan; Department of Neurosurgery, University of Jordan, Jordan
| | - Tareq M A Kanaan
- Faculty of Medicine, University of Jordan, Jordan; Department of Neurosurgery, University of Jordan, Jordan
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Rolle AM, Soboslay PT, Reischl G, Hoffmann WH, Pichler BJ, Wiehr S. Evaluation of the Metabolic Activity of Echinococcus multilocularis in Rodents Using Positron Emission Tomography Tracers. Mol Imaging Biol 2016; 17:512-20. [PMID: 25561014 DOI: 10.1007/s11307-014-0815-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE 2-Deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) has been used as a standard clinical positron emission tomography (PET) tracer for the follow-up of the rare but life-threatening parasitic disease alveolar echinococcosis (AE). Given that the disease is endemic in many countries in the northern hemisphere and the diagnosis is still challenging, the aim of our study was to evaluate further clinically relevant PET tracers as possible diagnostic tools for AE in vitro and in vivo. PROCEDURES Various clinically used PET tracers were evaluated in vitro and assessed in an in vivo AE animal model based on PET/magnetic resonance (MR) measurements. RESULTS In vitro binding assays displayed high uptake of [(18)F]FDG in a cell suspension of E. multilocularis tissue, whereas 3'-deoxy-3'-[(18)F]fluorothymidine ([(18)F]FLT) and [(11)C]choline were found to be taken up strongly by E. multilocularis vesicles. [(18)F]FDG and [(18)F]FLT displayed an elevated uptake in vivo, which appeared as several foci throughout the parasite tissue as opposed to [(18)F]fluoro-azomycinarabinofuranoside ([(18)F]FAZA) and [(11)C]choline. CONCLUSIONS Our data clearly demonstrate that the clinically applied PET tracer [(18)F]FDG is useful for the diagnosis and disease staging of AE but also has drawbacks in the assessment of currently inactive or metabolically weak parasitic lesions. The different tested PET tracers do not show the potential for the replacement or supplementation of current diagnostic strategies. Hence, there is still the need for novel diagnostic tools.
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Affiliation(s)
- Anna-Maria Rolle
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard Karls University, Röntgenweg 13, 72076, Tübingen, Germany
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14
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Tzili N, Ahbeddou S, Ahmimech J, Abboud H, Boutarbouch M, El Hassan A, Berraho A. Swollen eyelid reveals multiple intracranial hydatid cysts associated with a palpebral cyst. J Fr Ophtalmol 2015; 39:210-2. [PMID: 26598810 DOI: 10.1016/j.jfo.2015.06.005] [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: 05/24/2015] [Revised: 06/11/2015] [Accepted: 06/16/2015] [Indexed: 11/30/2022]
Abstract
We report a case of a hydatid cyst of the eyelid in a 12-year-old boy associated with cerebral involvement. The patient was initially treated by neurosurgeons for brain cysts. The course after an interval of two months was marked by regression of the palpebral cyst on albendazole.
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Affiliation(s)
- N Tzili
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco.
| | - S Ahbeddou
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - J Ahmimech
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - H Abboud
- Service de neurochirurgie, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - M Boutarbouch
- Service de neurochirurgie, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - A El Hassan
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
| | - A Berraho
- Service d'ophtalmologie B, hôpital des spécialités, CHU de Rabat, Rabat, Morocco
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15
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Saini J, Gupta RK, Jain KK. Intracranial infections: key neuroimaging findings. Semin Roentgenol 2014; 49:86-98. [PMID: 24342678 DOI: 10.1053/j.ro.2013.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Rakesh K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
| | - Krishan K Jain
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India
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16
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Hydatid disease located in the cerebellomedullary cistern. Case Rep Med 2014; 2014:271365. [PMID: 24782895 PMCID: PMC3982244 DOI: 10.1155/2014/271365] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/18/2014] [Indexed: 11/17/2022] Open
Abstract
Hydatid disease is an endemic zoonotic disease in many areas of the world. Liver, followed by lung, is the most commonly affected organ and involvement of other organs is rare. When brain is involved, lesions are typically supratentorial, and infratentorial localisation is even rarer. We present a 45-year-old woman with hydatid disease located in premedullary location compressing the brain stem, an exceedingly rare location for cerebral echinococcosis. Relevant literature regarding typical properties of cerebral disease was reviewed.
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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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18
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Abstract
Rhizobiales (formerly named Rickettsiales) cause in rare instances meningitis and meningovasculitis, respectively. In case of history of exposure, infection by Rhizobiales needs to be considered since both diagnosis and therapy may be extremely difficult and pathogen-specific. The same applies to protozoa; in this chapter, Babesia species, free-living amoebae and Entamoeba histolytica infection, including severe meningitis and brain abscess, infection by Trypanosoma species (South American and African trypanosomiasis) are discussed with respect to history, epidemiology, clinical signs, and symptoms as well as differential diagnosis and therapy. Parasitic flatworms and roundworms, potentially able to invade the central nervous system, trematodes (flukes), cestodes (in particular, Cysticercus cellulosae), but also nematodes (in particular, Strongyloides spp. in the immunocompromised) are of worldwide importance. In contrast, filarial worms, Toxocara spp., Trichinella spp., Gnathostoma and Angiostrongylus spp. are seen only in certain geographically confined areas. Even more regionally confined are infestations of the central nervous system by metazoa, in particular, tongue worms (=arthropods) or larvae of flies (=maggots). The aim of this chapter is (1) to alert the neurologist to these infections, and (2) to enable the attending emergency neurologist to take a knowledgeable history, with an emphasis on epidemiology, clinical signs, and symptoms as well as therapeutic management possibilities.
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Affiliation(s)
- Erich Schmutzhard
- Department of Neurology, Medical University Hospital Innsbruck, Innsbruck, Austria.
| | - Raimund Helbok
- Department of Neurology, Medical University Hospital Innsbruck, Innsbruck, Austria
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20
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Cerebral alveolar echinococcosis: a report of two cases. Clin Neurol Neurosurg 2012; 114:717-20. [PMID: 22244254 DOI: 10.1016/j.clineuro.2011.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 10/28/2011] [Accepted: 12/02/2011] [Indexed: 11/22/2022]
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21
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Mohindra S, Savardekar A, Gupta R, Tripathi M, Rane S. Varied types of intracranial hydatid cysts: radiological features and management techniques. Acta Neurochir (Wien) 2012; 154:165-72. [PMID: 21969224 DOI: 10.1007/s00701-011-1181-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 09/20/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Even when radiological images are considered pathognomic for intracranial hydatid cysts, subtle image characteristics are evident depending upon the status/types of hydatid cysts. These imaging features, if finely scrutinized, may help to modify conventional surgical techniques of cyst excision. METHODS From January 2006 to December 2011, nine patients (male:female 7:2, age range 4-44 years, median 7 years) harbouring intracranial hydatid cysts were managed at our centre. In addition to CT scans, all patients underwent plain and contrast-enhanced MRI scans. Based on these radiological findings, the types of hydatid cysts were characterized into simple or complicated (infected) cysts. Complicated cysts were further differentiated into ruptured or intact subtypes based on imaging features. Surgical procedures including the Dowling water dissection technique, in addition to head rotation, were performed for removing these cysts intact. RESULTS Children (n = 4) aged 6 years or less presented with increasing head size as the only complaint, while the rest of the patients (n = 5) had symptoms of raised intracranial pressure. MRI features of hypo-intensity on T1-weighted images, hyper-intensity on T2-weighted images, and non-contrast-enhancing cysts were noted for all simple cysts (n = 7), while iso- to mixed intensity on T1-weighted images and hyper-intensity on T2-weighted images with contrast-enhancing pericyst correctly diagnosed all complicated (infected) hydatid cysts (n = 2). One of these complicated cysts had spilled the infected contents outside the cyst wall, but within the confines of the cerebral parenchyma (pericyst). Such a case of contained spontaneously ruptured complicated hydatid cyst is described for the first time. At a median follow-up of 18 months, all patients remain free from cyst recurrence. CONCLUSION Subtle changes in radiological features of CNS hydatid cysts should be appreciated so as to diagnose the type of cyst correctly. The surgical strategy should be tailored according to the type of cyst for favourable outcome.
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Affiliation(s)
- Sandeep Mohindra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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22
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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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23
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Abdel Razek AAK, Watcharakorn A, Castillo M. Parasitic diseases of the central nervous system. Neuroimaging Clin N Am 2011; 21:815-41, viii. [PMID: 22032501 DOI: 10.1016/j.nic.2011.07.005] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This article reviews the characteristic imaging appearances of parasitic diseases of the central nervous system, including cysticercosis, toxoplasmosis, cystic echinococcosis, schistosomiasis, amebiasis, malariasis, sparganosis, paragonimiasis, and American and African trypanosomiases. Routine precontrast and postcontrast MR imaging helps in localization, characterization, delineation of extension, and follow-up of the parasitic lesions. Moreover, recently developed tools, such as diffusion, perfusion, and MR spectroscopy, help to differentiate parasitic diseases of the central nervous system from simulating lesions. Combining imaging findings with geographic prevalence, clinical history, and serologic tests is required for diagnosis of parasitic diseases of the central nervous system.
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24
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Wani NA, Kosar TL, Khan AQ, Ahmad SS. Multidetector-row computed tomography in cerebral hydatid cyst. J Neurosci Rural Pract 2011; 1:112-4. [PMID: 21808517 PMCID: PMC3139338 DOI: 10.4103/0976-3147.71728] [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: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Nisar A Wani
- Department of Radiodiagnosis & Imaging, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, India
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25
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Ozdol C, Yildirim AE, Daglioglu E, Divanlioglu D, Erdem E, Belen D. Alveolar hydatid cyst mimicking cerebellar metastatic tumor. Surg Neurol Int 2011; 2:13. [PMID: 21427774 PMCID: PMC3046418 DOI: 10.4103/2152-7806.76281] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 01/04/2011] [Indexed: 01/24/2023] Open
Abstract
Background: Echinococcus multilocularis is a rare infestation in the world with a particularly increased incidence mainly in South America, Central Europe and Asia. Progression of alveolar Echinococcosis is more aggressive that can metastasize to lungs, brain and bones however brain involvement is usually rare with an incidence about 1%. Case Description: We report a 23-year-old man with a cerebellar Echinococcosis multilocularis mimicking a metastatic cerebellar tumor. Suboccipital craniotomy was performed for gross total removal of the tumor. Histopathological specimens confirmed the diagnosis of Echinococcosis multilocularis. Conclusion: Radical surgical excision should be recommended for single Echinococcosis multilocularis lesions particularly at infratentorial localization.
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Affiliation(s)
- Cagatay Ozdol
- Ankara Numune Education and Research Hospital, Neurosurgery Clinics, Ankara, Turkey
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A 2-year-old girl with fever, abdominal pain, and lung cavities. Pediatr Infect Dis J 2010; 29:1061, 1065-6. [PMID: 21046702 DOI: 10.1097/inf.0b013e3181e57e5e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ukkola-Pons E, Ferrand-Sorbet S, Banayan E, Polivka M, Savatovsky J, Heran F. Magnetic resonance spectroscopy of a cerebral parasitic cyst. J Neuroradiol 2010; 38:260-2. [PMID: 20950859 DOI: 10.1016/j.neurad.2010.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 07/07/2010] [Accepted: 07/12/2010] [Indexed: 11/18/2022]
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Basraoui D, El Idrissi I, Jalal H, Hiroual M, Essadki O, Ousehal A, Aniba K, Ghannane H, Lmejjati M, Ait Benali S. [Intracranial hydatid cysts in children: a report of 9 cases]. JOURNAL DE RADIOLOGIE 2010; 91:293-6. [PMID: 20508560 DOI: 10.1016/s0221-0363(10)70041-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To illustrate the value of cross-sectional imaging (CT, MRI) for the diagnosis and follow-up of intracranial hydatid cysts in children. MATERIALS AND METHODS Retrospective study of 9 cases of intracranial hydatid cysts in children seen over a period of 8 years. Precontrast and postcontrast 5 mm thick axial CT images were obtained in 7 cases. Noncontrast sagittal, axial and coronal T1W and T2W images were obtained in 2 cases. RESULTS Mean patient age was 7.5 years. Intracranial hypertension was the main presenting clinical symptom. A single supratentorial cyst with significant mass effect upon the ventricular system and midline structures was observed in all cases. All patients underwent surgery with good outcome in all cases. CONCLUSION CT is the imaging modality of choice for diagnosis and postoperative follow-up of intracranial hydatid cysts in children. MRI is most helpful for further characterization when multiple or atypical cysts are present to optimize management.
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Affiliation(s)
- D Basraoui
- Service de Radiologie, Hôpital mère-enfant (Arrazy), CHU Mohammed VI, Marrakech, Maroc.
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Primary soliter and multiple intracranial cyst hydatid disease: report of five cases. Brain Dev 2009; 31:228-33. [PMID: 18485645 DOI: 10.1016/j.braindev.2008.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2007] [Revised: 03/22/2008] [Accepted: 03/30/2008] [Indexed: 11/21/2022]
Abstract
Echinococcosis is a parasitic disease caused by infestation of various body tissues by the encysted larvae of Echinococcosis granulosa, the tapeworm. The disease because of the inefficiency of environmental health and protective care and dealing with animals is prevalent in South America, Africa, Australia, the Mediterranean countries and the Middle East. Cerebral hydatid cysts are rare and comprise only 0.5-3% of all reported hydatid cysts. Brain involvement is seen rare and primary form is very rare. We report five cases of primary hydatid disease of the brain. In three cases (60%), brain involvement was solitary, while two cases (40%) had primary multiple intracranial hydatid cysts. This study confirms that hydatid disease is a difficult health problem in Turkey.
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Ntusi NA, Horsfall C. Severe disseminated hydatid disease successfully treated medically with prolonged administration of albendazole. QJM 2008; 101:745-6. [PMID: 18448474 DOI: 10.1093/qjmed/hcn058] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Ntobeko A Ntusi
- Department of Internal Medicine, University of Cape Town, Cape Town, South Africa.
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31
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Takci E, Sengul G, Akar A, Uslu H, Alper F, Erdogan F, Aydin IH. Alveolar echinococcosis of the brain in five patients. J Clin Neurosci 2008; 15:1105-9. [PMID: 18653340 DOI: 10.1016/j.jocn.2007.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 09/27/2007] [Accepted: 09/30/2007] [Indexed: 12/13/2022]
Abstract
Cerebral alveolar echinococcis is a biologically aggressive infestation that mimics a malignant neoplasm radiologically and macroscopically. This paper describes the clinical and radiological aspects of the disease, with new diagnostic studies, and discusses the surgical treatment of this infestation. The records of five patients with cerebral alveolar echinococcis treated at our center between 2000 and 2004 were reviewed. Three patients underwent radical surgical treatment and received antihelminthic therapy post-operatively, two of whom experienced asymptomatic recurrence. Two patients with multiple lesions were treated with antihelminthic therapy alone. The prognosis was poor for these patients. Radical surgery combined with antihelminthic therapy of sufficient duration are mandatory to prevent the progression of symptoms but the disease continues to be difficult to cure.
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Affiliation(s)
- Erhan Takci
- Department of Neurosurgery, Medical School, Ataturk University, 25070, Yenisehir, Erzurum, Turkey
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Gana R, Skhissi M, Maaqili R, Bellakhdar F. Multiple infected cerebral hydatid cysts. J Clin Neurosci 2008; 15:591-3. [PMID: 18342511 DOI: 10.1016/j.jocn.2006.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2006] [Revised: 10/31/2006] [Accepted: 11/01/2006] [Indexed: 10/22/2022]
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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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Per H, Gumus H, Kumandas S, Tucer BL, Yikilmaz A, Menku A, Coskun A, Kurtsoy A. Gigantic cerebral hydatid cysts in childhood. Ann Saudi Med 2007; 27:60-1. [PMID: 17277497 PMCID: PMC6077019 DOI: 10.5144/0256-4947.2007.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2006] [Indexed: 11/22/2022] Open
Affiliation(s)
- H Per
- Department of Pediatric Neurology, Erciyes University, Kayseri, Turkey.
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Sales LV, Velasco TR, Funayama S, Ribeiro LT, Andrade-Valença LP, Neder L, Fernandes RMF, Araujo D, Machado HR, Santos AC, Leite JP. Relative frequency, clinical, neuroimaging, and postsurgical features of pediatric temporal lobe epilepsy. Braz J Med Biol Res 2006; 39:1365-72. [PMID: 16906314 DOI: 10.1590/s0100-879x2006001000013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Accepted: 06/20/2006] [Indexed: 11/22/2022] Open
Abstract
We describe the relative frequency, clinical features, neuroimaging and pathological results, and outcome after pharmacological or surgical intervention for a series of pediatric patients with temporal lobe epilepsy (TLE) from an epilepsy center in Brazil. The medical records of children younger than 12 years with features strongly suggestive of TLE were reviewed from January 1999 to June 1999. Selected children were evaluated regarding clinical, EEG, and magnetic resonance imaging (MRI) investigation and divided into three groups according to MRI: group 1 (G1, N = 9), patients with hippocampal atrophy; group 2 (G2, N = 10), patients with normal MRI, and group 3 (G3, N = 12), patients with other specific temporal lesions. A review of 1732 records of children with epilepsy revealed 31 cases with TLE (relative frequency of 1.79%). However, when the investigation was narrowed to cases with intractable seizures that needed video-EEG monitoring (N = 68) or epilepsy surgery (N = 32), the relative frequency of TLE increased to 19.11 (13/68) and 31.25% (10/32), respectively. At the beginning of the study, 25 of 31 patients had a high seizure frequency (80.6%), which declined to 11 of 31 (35.5%) at the conclusion of the study, as a consequence of pharmacological and/or surgical therapy. This improvement in seizure control was significant in G1 (P < 0.05) and G3 (P < 0.01) mainly due to good postsurgical outcome, and was not significant in G2 (P > 0.1, McNemar's test). These results indicate that the relative frequency of TLE in children was low, but increased considerably among cases with pharmacoresistant seizures. Patients with specific lesions were likely to undergo surgery, with good postoperative outcomes.
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Affiliation(s)
- L V Sales
- Departamento de Neurologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes 3900, 14049-900 Ribeirão Preto, SP, Brazil
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Brahem M, Hlel K, Ayadi A, Bedoui A, Hmila F, Mahjoub B, Boussoffara R, Sfar MT. [Cerebral hydatid cysts in children: 4 cases]. Med Mal Infect 2006; 36:434-7. [PMID: 16890392 DOI: 10.1016/j.medmal.2006.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Accepted: 04/10/2006] [Indexed: 11/15/2022]
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.
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Affiliation(s)
- M Brahem
- Service de pédiatrie, CHU Taher-Sfar-Mahdia, 5100 Tunis, Tunisie.
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Yang YR, Sun T, Zhang JZ, McManus DP. Molecular Confirmation of a Case of Multiorgan Cystic Echinococcosis. J Parasitol 2006; 92:206-8. [PMID: 16629342 DOI: 10.1645/ge-606r.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We report on the results of radical surgery performed on a 10-yr-old Chinese female with multiple echinococcosis lesions and the diagnosis of the infection by imaging, histology, serology, and DNA analysis. Molecular genotyping provided unequivocal proof that the patient was infected with Echinococcus granulosus, the cause of cystic echinococcosis.
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Affiliation(s)
- Y R Yang
- Ningxia Medical College, Ningxia Hui Autonomous Region, 75004, PR China
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Yang YR, Vuitton DA, Jones MK, Craig PS, McManus DP. Brain metastasis of alveolar echinococcosis in a hyperendemic focus of Echinococcus multilocularis infection. Trans R Soc Trop Med Hyg 2005; 99:937-41. [PMID: 16165174 DOI: 10.1016/j.trstmh.2005.04.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2005] [Revised: 04/18/2005] [Accepted: 04/19/2005] [Indexed: 11/26/2022] Open
Abstract
An unusual female case, with alveolar echinococcosis (AE) disseminated from the primary hepatic lesion to the brain by metastasis formation, was retrospectively identified during a community survey in Ningxia Hui Autonomous Region, northwest China in 2003. Among possible metastases of hepatic AE, locations to the brain are rare and usually fatal; and they have especially been assigned to concomitant immune suppression. An enhancing role of pregnancy, which may be suspected in this case, the favourable outcome after surgery and chemotherapy, and also a mental disability in a child following long-term intrauterine exposure to mebendazole, make the report particularly unique.
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Affiliation(s)
- Y R Yang
- Molecular Parasitology Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, Q 4006, Australia
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Abstract
Parasitic infection of the nervous system can produce a variety of symptoms and signs. Because symptoms of infection are often mild or nonspecific, diagnosis can be difficult. Familiarity with basic epidemiological characteristics and distinguishing radiographic findings can increase the likelihood of detection and proper treatment of parasitic infection of the nervous system. This article discusses the clinical presentation, diagnosis, and treatment for some of the more common infections of the nervous system caused by cestodes, trematodes and protozoans: Echinococcus spp., Spirometra spp. (sparganosis), Paragonimus spp., Schistosoma spp., Trypanosoma spp., Naegleria fowlerii, Acanthamoeba histolytica, and Balamuthia mandrillaris.
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Affiliation(s)
- M D Walker
- Department of Neurology, University of Washington School of Medicine, Seattle, Washington 98104, USA
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41
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da Rocha AJ, Maia ACM, Ferreira NPDF, do Amaral LLF. Granulomatous diseases of the central nervous system. Top Magn Reson Imaging 2005; 16:155-87. [PMID: 16340335 DOI: 10.1097/01.rmr.0000189109.62899.a1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Infectious diseases of the central nervous system (CNS), particularly those accompanied by the formation of granulomas, are a constant diagnostic challenge in some specific regions of the world, above all in developing countries. The pattern of image seen on CT or MR scan is the result of the inter-relations between the individual characteristics of the infectious agent and the capacity of each host to mount an appropriate inflammatory response to that specific type of aggression, inside one particular compartment of the CNS. Taking these parameters into account we will discuss the several patterns of image found in parasitic, bacterial, and fungal granulomatous infections.
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Abstract
BACKGROUND As international travel for business and pleasure becomes part of contemporary lifestyle, the clinician today is confronted with an increasing number of travelers returning ill with unfamiliar syndromes. The physician will encounter a myriad of patients with exotic infections, emerging infectious diseases, or resurgent Old-World infections. REVIEW SUMMARY This review article will discuss salient points of important infectious diseases associated with overseas travel, provide a syndromic approach to the traveler who returns with neurologic manifestations, and list resources for additional diagnostic, therapeutic, and preventive information. CONCLUSIONS As many of infections acquired in other countries can directly or indirectly affect the nervous system, the care of the ill traveler often falls into the hands of neurologists. The contemporary neurologist should therefore be knowledgeable of the clinical manifestations, potential complications, and appropriate management of region-specific infections.
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Affiliation(s)
- May H. Han
- Department of Neurology, University of Washington School of Medicine, Seattle, Washington
| | - Joseph R. Zunt
- Department of Neurology, University of Washington School of Medicine, Seattle, Washington
- Center for AIDS and STD, University of Washington School of Medicine, Seattle, Washington
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Raether W, Hänel H. Epidemiology, clinical manifestations and diagnosis of zoonotic cestode infections: an update. Parasitol Res 2003; 91:412-38. [PMID: 13680371 DOI: 10.1007/s00436-003-0903-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2003] [Accepted: 05/21/2003] [Indexed: 02/06/2023]
Abstract
This paper reviews the literature on zoonotic cestode infections with specific reference to the years 1999-2003. The sources and prevalence of various zoonotic tapeworm infections caused by adult and larval stages of the genera Taenia, Echinococcus, Diphyllobothrium, Hymenolepis and Dipylidium continue to be an important cause of morbidity and mortality, not only in most underdeveloped countries but also in industrialized countries, particularly in rural areas or among immigrant groups from endemic areas. The review gives a detailed report on recent molecular epidemiological studies on the taxonomy and phylogenetic variations in Echinococcus granulosus, immunological tests and imaging techniques used in epidemiological surveys and clinical investigations of important adult and larval tapeworm infections of animals and humans. Larval stages or metacestodes of Taenia solium, Echinococcus spp. and pseudophyllidean tapeworms (Spirometra syn. Diphyllobothrium spp.) may reside in various tissues of their intermediate hosts, including humans. In particular, Cysticercus cellulosae (T. solium) and the larvae of E. granulosus, and E. multilocularis, which are predominantly located in the liver, lungs and central nervous system forming various types of cysts, lead to a complex of systemic diseases such as cysticercosis, cystic echinococcosis and alveolar echinococcosis, respectively. Relatively rare clinical manifestations are seen in the muscles, subcutaneous tissue, spleen, kidneys, bones and body cavities.
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Affiliation(s)
- W Raether
- Fa Aventis, ADMEP /Q0/10, 65926 Frankfurt am Main, Germany
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