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Multiple intracranial hydatidosis.

T J Al Zain1, S H Al-Witry, H M Khalili

  • 1Department of Neurosurgery College of Medicine, Baghdad University, Iraq.

Acta Neurochirurgica
|November 16, 2002
PubMed
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Multiple intracranial hydatidosis (MIH) is a rare, serious neurological disease. This study investigated MIH cases, proposing a new classification and exploring infestation mechanisms for better understanding and treatment.

Area of Science:

  • Neurology
  • Parasitology
  • Infectious Diseases

Background:

  • Multiple intracranial hydatidosis (MIH) is a rare condition with severe neurological effects, high recurrence rates, and significant mortality.
  • The underlying causes and mechanisms of multiple brain infestations remain poorly understood.
  • Existing classifications do not fully explain the varied cyst locations, appearances, and recurrence patterns.

Purpose of the Study:

  • To evaluate the incidence, localization, complications, treatment, and recurrence of MIH in a series of patients.
  • To elucidate the mechanisms behind multiple infestations.
  • To propose a novel classification system for MIH.

Main Methods:

  • Retrospective analysis of 34 patients with MIH treated between 1976 and 1999.

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  • Diagnosis primarily via CT scan, confirmed surgically; iatrogenic cases excluded.
  • Cyst removal using Arana-Iñiguez's method with Dowling's technique; histopathological confirmation of scolices; 3-14 year follow-up.

    • Main Results:

    • The majority of patients (76.4%) were under 20 years old; female predominance (1.83:1.0 ratio).
    • Clinical presentation included increased intracranial pressure and focal neurological deficits.
    • Operative mortality was 10.7%, overall mortality 17.6%; 46.4% had a good outcome, and 35% experienced recurrence.

    Conclusions:

    • MIH is exceptionally rare, with only 77 cases reported globally.
    • The high incidence in Iraq suggests a potential unique strain of Echinococcus granulosis.
    • Recommendations are made for MIH terminology and classification.