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Intracranial hydatid cyst in children: report of 30 cases
Sailike Duishanbai1, Dangmuren Jiafu, Huairong Guo
1Neurosurgery Department, First Teaching Hospital, Xinjiang Medical University, Urumqi, Xinjiang, 830054, China. serickd@yahoo.com
Insights
Pediatric intracranial hydatid cysts often cause increased intracranial pressure. Surgical removal is effective, but intact removal is crucial to prevent complications and ensure favorable outcomes in children.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Infectious Diseases
Background:
- Hydatid cysts, caused by Echinococcus granulosus, can affect the central nervous system, particularly in endemic areas.
- Pediatric intracranial hydatid cysts are rare but can lead to significant neurological morbidity.
Purpose of the Study:
- To analyze clinical manifestations, radiological findings, and surgical outcomes of pediatric intracranial hydatid cysts.
- To evaluate the efficacy and safety of surgical management for these lesions in children.
Main Methods:
- Retrospective review of 30 pediatric patients with intracranial hydatid cysts treated surgically.
- Analysis of clinical data, neuroimaging (CT and MRI), and surgical outcomes.
Main Results:
- Headache and vomiting were the most frequent initial symptoms.
- Neurological deficits occurred in 15 cases due to mass effect; epilepsy was rare.
- Computed tomography (CT) showed homogeneous, low-density cystic lesions; magnetic resonance imaging (MRI) revealed characteristic signal intensities.
- Complete surgical removal was achieved in 29 out of 30 cases, with one mortality due to cyst rupture.
Conclusions:
- Increased intracranial pressure is a common presentation of cerebral hydatid disease in children.
- CT and MRI are essential for diagnosis.
- Surgery is the primary treatment, with intact removal being critical for successful outcomes.
- Postoperative medical treatment is recommended for multiple or deep-seated lesions.
Purpose:
To analyze the clinical manifestations, radiological features, and surgical outcomes in 30 pediatric intracranial hydatid cysts.
Methods:
We reviewed the clinical, radiological, and surgical aspects of pediatric intracranial hydatid cysts patients who received surgical treatment at the Neurosurgical department of Xinjiang Medical University between the years 1985 to 2007, retrospectively.
Results:
Headache and vomiting were the most common initial symptoms in our series. Neurological deficits from the mass effect of the cysts were seen in 15 cases, including hemiparesis, visual deficit, and diplopia. Epilepsy occurred only in one patient with temporal lobe hydatid cyst. On computed tomography (CT), it presented as a round-shaped and thin-walled homogeneous low-density cystic lesion without surrounding edema and enhancement. Only five patients had a magnetic resonance imaging (MRI) scan, and presented low signal intensity on T1-weighted image and high signal intensity on T2-weighted image. Surgical removal of cyst was performed in all cases and intact removal was done in 29 cases. However, one cyst ruptured during the dissection of cyst wall, thus, resulting in one death. There were no additional neurological deficits which were caused directly by surgery.
Conclusion:
Increased intracranial pressure is common in patients with cerebral hydatid disease. CT and MRI are the first-line diagnostic procedures. Surgery is the treatment of choice for the majority of intracranial hydatid cysts. Multiple and deep seated lesions should receive medical treatment postoperatively.
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