Giant Hydatid Cyst in the Posterior Fossa of a Child: A Case Report

Hydatid cyst of the brainstem: The rarest of the rare locations for echinococcosis

Hydatidosis, caused by the larval stage of Echinococcus granulosus, is a zoonotic disease typically affecting the liver and lungs. Cerebral localizations are rare, especially in the brainstem. We present a case of a 9-year-old boy with a brainstem hydatid cyst. The patient exhibited progressive walking difficulties and limb impairment. MRI revealed a brainstem mass consistent with a hydatid cyst. Due to the lesion's size and location, surgical intervention was necessary. The cyst was decompressed and removed without complications, followed by albendazole treatment. Postoperative recovery was uneventful, and the patient showed no signs of recurrence after 2 years. This case highlights the importance of early diagnosis, precise surgical techniques, and thorough postoperative care in managing rare cerebral hydatid cysts.

Diagnosis and Management Approaches for Cerebellar Hydatid Cysts: A Systematic Review of Cases

Cerebellar hydatid cysts are uncommon lesions, with limited cases reported in the literature. This systematic review aimed to summarize current diagnostic and management approaches, given the low suspicion index of hydatid cysts in the cerebellum. The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023437853. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) reporting guidelines. Two independent researchers searched PubMed, Scopus, and Google Scholar databases on June 27, 2023. We included 15 studies published between 1965 and 2022, comprising 12 case reports and three case series. A pooled analysis of reported cases (nine females and seven males) with cerebellar hydatid cysts revealed a mean age of 24 ± 20 years. Most of the cases were reported in Turkish hospitals (n = 8). The prominent signs and symptoms observed were headaches (10, 62.5%), ataxic gait (9, 56.25%), and visual disturbances (9, 56.25%). The time from symptom onset to hospital visit varied, with most patients seeking medical attention within the first three months. The left cerebellar hemisphere was the most common location of the cysts (6, 37.5%), and compression of the fourth ventricle was frequently observed. Computed tomography (CT) and magnetic resonance imaging (MRI) were the primary diagnostic tools used in three-fourths of cases, and surgical intervention was the primary treatment approach. Albendazole and praziquantel were commonly prescribed postoperatively, and two patients underwent preoperative needle decompression. This systematic review contributes to a better understanding of cerebellar hydatid cysts and guides future research and clinical management of this entity.

Posterior Fossa Epidural Hydatid Cyst in the Adult

ABSTRACT

Hydatid cyst is an important parasitic disease especially in endemic regions. Hydatid cysts are most commonly found in the liver and lungs and only 1% to 2% of the cysts reach the brain. Intracranial hydatid cysts are usually supratentorial and majority of cases are children and young adults. In this case report, a 55-year-old woman who lives in rural area in Turkey, admitted to our clinic with severe headache, neck pain, gait disturbance, and vomiting. Her neurological examination revealed cerebellar ataxia and left dysmetria. Radiological findings were compatible with hydatid cyst. On the 3rd of antihelmintic therapy, the patient underwent suboccipital craniotomy and epidural cyst was excised using Dowling technique without rupture of the cyst wall. Patient's symptoms improved postoperatively. Although hydatid cyst in posterior fossa is a very rare entity, it should be kept in mind in patients with intracranial cystic lesions who live in endemic regions.

[Hydatid cyst of the posterior fossa]

L'hydatidose est une parasitose cosmopolite endémique au Maroc. L'échinococcose cérébrale est rare représentant 1 à 2% de l'ensemble des hydatidoses de l'homme et la localisation auniveau de la fosse postérieure est exceptionnelle. Nous rapportons le cas d'un enfant âgé de 12 ansadmis pour syndrome d'hypertension intracrânienne évoluant depuis trois mois. La tomodensitométrie cérébrale a objectivé une formation kystique de la fosse postérieurene se rehaussant pas après injection du produit de contraste. L'intervention chirurgicale révélait un kyste hydatique. Ce diagnostic aété par la suite confirméparl'examen anatomo-pathologique. Le patient a reçuuntraitement médical à base d'albendazole en postopératoire. L'évolutionétait favorable six mois plus tard.

[Multimodal therapy concepts for failed back surgery syndrome]

Failed back surgery syndrome (FBSS) is a frequent complication (15-40 %) of lumbar disc surgery and is rarely successfully treated by surgery with the exception of a re-prolapse associated with radicular pain. Multimodal pain treatment, however, is indicated by a lack of pathoanatomical correlates, unclear cause and psychosocial risk factors.This review describes a standardized non-operative treatment starting with broad interdisciplinary clarification by medical, psychological and physiotherapeutic means (assessment).If the conditions for multimodal pain therapy are met, the OPS 8‑918-procedure can be applied to avoid chronic developing pain. In doing so, the already issued quality standards and guidelines for documentation should be respected.

Intra cranial hydatid cyst: A case report of total cyst extirpation and review of surgical technique

Hydatid cysts commonly affect liver and lung but it can also affect the brain in rare cases. We report a case of 22 year female with history of headache for one and half years. Intracranial hydatid cyst was diagnosed on computed tomography scan and magnetic resonance imaging. The cyst was delivered without rupture using hydrostatic dissection followed by post-operative anthelminthic medication. Surgery remains to be the standard management. Amongst the surgical techniques described, Dowling's technique is the most acceptable. However, care must be taken in to avoid rupture of the cyst peroperatively which can result in subsequent complications and recurrence. Albendazole and corticosteroids can be used as adjunct to surgical treatment in selective cases.

Hydatid cyst of the ambient cistern radiologically mimicking an arachnoid cyst

Hydatid cysts of the posterior fossa are extremely rare. Intracranial hydatid cysts are more common in children and occur more frequently in the supratentorial space. A 7-year-old boy was admitted to the emergency department because of intense headache, nausea, vomiting, and progressive drowsiness that developed within the period of a week. On radiological examination a round, 2.5 × 2.5-cm cystic lesion appeared in the ambient cistern and caused hydrocephalus as a result of extrinsic aqueductal stenosis. The cyst was successfully removed using the puncture, aspiration, irrigation, and resection technique via an infratentorial-supracerebellar approach with the patient in the sitting position. The authors here described an unusual case of a hydatid cyst in the left ambient cistern with hydrocephalus due to extrinsic aqueductal stenosis, which seems to be the first such case in the literature. Hydatid cyst may be considered in the differential diagnosis of arachnoid cysts of the quadrigeminal cistern to determine which surgical procedure to perform and to avoid unexpected complications.