Intracranial hydatid cyst. Dilemma in diagnosis and management

Intracranial hydatid disease is a parasitic infection that affects children in endemic areas such as the Mediterranean, South America, and Australia. In non-endemic areas, it is rare and may pose a diagnostic dilemma. We review a boy who presented with a right cerebral cyst. All investigations were negative, and hydatid cyst was encountered upon intra-operative exploration. We review the available diagnostic modalities, and the difficulty in reaching a preoperative diagnosis. We also review the surgical and medical treatment strategies. A cerebral hydatid cyst should be considered in children with cystic brain lesions even in non-endemic areas. Since serologic tests are frequently negative, the most reliable methods in reaching a diagnosis are radiological evaluation and histopathological examination. The cyst has a typical appearance on CT and MRI and this bears special importance on the treatment strategy where the cyst is best removed intact to avoid recurrence or anaphylaxis.