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Hydatid cyst of the ambient cistern radiologically mimicking an arachnoid cyst

Ahmet Metin Sanlı1, Erhan Türkoğlu, Hayri Kertmen

  • 1First Neurosurgery Department, M.H. Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.

Journal of Neurosurgery. Pediatrics
|July 17, 2012
PubMed

Insights

A rare posterior fossa hydatid cyst in a child caused obstructive hydrocephalus. Surgical removal via an infratentorial-supracerebellar approach was successful, highlighting the need to consider hydatid cysts in differential diagnoses.

Area of Science:

  • Neurology
  • Parasitology
  • Pediatric Neurosurgery

Background:

  • Posterior fossa hydatid cysts are exceptionally rare, with intracranial hydatid cysts more commonly found in children and supratentorial locations.
  • Hydatid cysts, caused by Echinococcus granulosus, typically manifest in the liver and lungs, with central nervous system involvement being infrequent.

Observation:

  • A 7-year-old boy presented with symptoms of increased intracranial pressure, including headache, nausea, vomiting, and drowsiness.
  • Radiological imaging revealed a cystic lesion in the ambient cistern causing extrinsic aqueductal stenosis and obstructive hydrocephalus.

Findings:

  • The study details the successful surgical resection of a 2.5 x 2.5 cm hydatid cyst from the left ambient cistern using the puncture, aspiration, irrigation, and resection (PAIR) technique.
  • The surgical approach utilized was infratentorial-supracerebellar with the patient in the sitting position.

Implications:

  • This case represents the first reported instance of a hydatid cyst in the ambient cistern causing hydrocephalus due to extrinsic aqueductal stenosis.
  • Hydatid cysts should be included in the differential diagnosis for quadrigeminal cistern arachnoid cysts to guide appropriate surgical planning and prevent complications.

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