Computed tomography of intracerebral echinococcal cysts in children

Computed tomography in pediatric patients with intracerebral cysts due to Echinococcus granulosus is diagnostic and specific and usually shows a single supratentorial round nonenhancing thin-walled cyst with CT density measurements near zero. Small calcified portions of the cyst wall, which are not visible on skull radiography, may be seen with CT and help differentiate echinococcal cysts from other cystic lesions. Preoperative diagnosis is important because, on entering the dura, an echinococcal cyst must not be lacerated or fluid that contains infectious scolices may be spilled, causing additional cysts to form. Of five pediatric patients studied, one patient died shortly after surgery but the other four patients had good recovery even though their cysts were large and their symptoms long-standing and severe. Even patients who present in coma should be considered operative candidates and given every chance to recover.