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Primary Hydatid Cyst of the Brain in a Child: A Case Report
Alessia Imperato1, Alessandro Consales2, Marcello Ravegnani2
1Department of Neurosciences and Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università Degli Studi Federico II, Naples, Italy.
Insights
Primary intracranial hydatid cysts, a rare form of echinococcosis, require prompt diagnosis and surgical removal. Early detection and complete excision of these brain cysts in children are crucial for favorable outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Primary intracranial hydatid cyst is a rare manifestation of human echinococcosis.
- Rupture of these cysts can lead to severe anaphylactic reactions and dissemination.
Observation:
- A 9-year-old boy presented with symptoms of intracranial hypertension.
- Neuroimaging revealed a large intra-axial cyst with calcification and hydrocephalus.
- MR spectroscopy identified specific metabolites within the cyst.
Findings:
- Neuroradiological findings suggested a hydatid cyst.
- The patient was treated with albendazole and surgical en bloc removal.
- Post-operative recovery was uneventful, with laboratory confirmation of brain echinococcosis.
Implications:
- Hydatid echinococcosis should be considered in the differential diagnosis of intracerebral cysts in children from endemic areas.
- Complete surgical removal of intact cysts is key for favorable outcomes.
- Early diagnosis and intervention are critical for managing this rare condition.
Background:
Primary intracranial hydatid cyst is a rare location of human echinococcosis whose spontaneous, traumatic or even iatrogenic rupture, as in case of misdiagnosis, may cause anaphylactic reactions and dissemination.
Case Report:
We discuss the management of a 9-year-old boy who was admitted to our Emergency Department with an intracranial hypertension syndrome. Head CT scan and brain MRI showed a huge intra-axial right temporo-parieto-occipital cyst with a marginal calcification, associated with left ventricular uncompensated hydrocephalus. DTI showed displacement of the ipsilateral corticospinal tract, whereas MR spectroscopy showed absence of normal brain metabolites and presence of succinate and lactate within the cyst. A diagnosis of hydatid cyst was then presumed on the basis of the neuroradiological findings. Empiric chemotherapy with albendazole was instituted and surgical en bloc removal of the cyst was obtained, allowing the patient to recover without complications. Diagnosis of brain echinococcosis was confirmed by laboratory tests.
Conclusions:
HE is still an endemic manifestation in some rural areas of the world, and it should be included in the differential diagnosis of children living in or coming from an endemic country who present with an intracerebral cyst. Early diagnosis and complete surgical removal of the intact cyst are the main factors that determine a favourable outcome.
