Cerebral hydatid cysts: technique and pitfalls of surgical management

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>Hydatid cysts are rare, but most often they occur in the liver and lungs. Cerebral manifestation is very rare, and surgery is the main treatment. The goal of surgery is to remove the cysts in toto without rupture. The aim of this study was to investigate the surgical technique of removing cerebral hydatid cysts and to show the possible pitfalls of surgery.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This study included 17 patients who underwent surgery for an intracranial hydatid cyst. The Dowling technique was used in all patients. This technique is based on the large cranial opening, careful handling, meticulous cortical dissection, and removal of the cyst by hydrostatic assistance.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>The hydatid cysts were removed unruptured in 88% of the cases. The cysts ruptured intraoperatively in 2 patients, and the ventricular system was opened in 1 of them. Anaphylactic reaction or chemical meningitis did not occur, but recurrence and spinal seeding were observed in the follow-up of these patients. The thin cyst wall, periventricular locations, and microadhesions to the surrounding brain tissue were the main surgical problems. None of the patients died after the surgery.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Although this technique seems safe and easy, there are some pitfalls concerning the cyst location and surgical approach. Successful management requires a flexible therapeutic strategy and meticulous dissection by an experienced surgeon.</jats:p></jats:sec>

Primary multiple cerebral hydatid disease: still symptomatic despite pathologically confirmed death of the cyst

“…Magnetic resonance and computerized tomography scans characteristically show hydatid cysts as spherical, well-defined, non-enhancing cystic lesions without peripheral edema. The cysts in MRI are seen as non-contrast enhancing, isointense lesions in both T1-and T2-weighted images (8,9,10,14,30). Neither perilesional edema nor rim fashion contrast enhacement are common radiological findings of hydatid cysts.…”

Epilepsy: Unusual presentation of cerebral hydatid disease in children

“…The diagnosis relies on serologic tests and imaging techniques CT and MRI. Because of his rarity, experience with intracranial hydatid disease at a single institution has been very limited, and the Dowling technique is widely used as a surgical treatment [2]. In this report we describe the clinical features, radiological findings and surgical outcome of cerebral hydatid cyst.…”

“…This is an endemic manifestation that is more frequently found in Mediterranean countries, the Middle East, South America, and Australia, and this entity affects particularly those involved with sheep and cattle rising [2]. However, because of modern day travel and population movement, it may be encountered in any part of the globe [3].…”

Recurrence of A Cerebral Hydatid Cyst

“…Cerebral cyst hydatid disease is an extremely rare entity clinically characterized by the structure of the cyst, size, its location in the cranium and effect on other cranial structures [1].…”

“…Headache, nausea and vomiting are among the early symptoms that are commonly encountered [1]. Diagnosis is made based on clinical and laboratory findings together with imaging studies.…”