Cerebral Cystic Echinococcosis in the Light of Our Experience

Abstract

Cerebral cystic echinococcosis (CCE) is rare and constitutes 1-2% of all cystic echinococcosis. The cysts are usually solitary and most frequently located in the supratentorial region. CCE is classified as primary and secondary. The primary cysts developed from the embryos which escaped from the filter systems are more frequent and usually solitary and fertile. The secondary cysts result from spontaneous, traumatic or surgical rupture of the primary CCE by embolization of scolices. They are usually multiple and infertile and do not have brood capsule or scolices. Symptoms usually develop slowly and are usually due to increased intracranial pressure and depend on the location of the cyst. Diagnosis is made by evaluation of both clinical and laboratory findings. Computed tomography and magnetic resonance imaging is successful in the diagnosis. The cysts are observed as spherical, well defined, with thin regular margins by these methods. The most appropriate treatment method is total surgical removal of the cyst without rupture by using Dowling's method. However, when it is not possible to remove without rupture, the cyst should be removed totally after puncture and aspiration of contents of the cyst. After removal of large cysts, complications such as porencephalic cysts and subdural hemorrhage can occur postoperatively.