Intracranial hydatid cysts in children

Brain involvement in hydatid disease occurs in 1 to 2% of all Echinococcus granulosus infections. Fifty to 75% of intracranial hydatid cysts are seen in children. This study included 19 children who underwent surgery for intracranial hydatid cysts between January 1979 and September 1992. There were 12 boys and 7 girls, ages 3 to 16 years (mean, 8.1 yr). Headache and vomiting were the predominant symptoms. Papilledema was present in 16 patients, and 2 patients had secondary optic atrophy. A round, cystic lesion without perifocal edema and rim enhancement was detected on the computed tomographic scans of 13 patients. The cystic lesions with rim enhancement and perifocal edema were noted on the computed tomographic scans of 3 patients. Of these three patients, two subsequently had a recurrence. Total removal of the cyst without rupture was achieved in 12 patients. Only a 3-year-old boy in whom the cyst ruptured at surgery died. Seven patients in whom either the hydatid cyst ruptured at surgery or there was systemic hydatid disease received mebendazole therapy. Mebendazole seems to be effective in hydatid disease. Cerebral hydatid cysts should be removed in toto without rupture. The preoperative diagnosis is very important in planning surgery. When a cystic lesion is detected on computed tomographic scan, hydatid disease should be taken into consideration in countries where hydatid disease is endemic.