Cerebrovascular occlusive disease: hydatidosis

Abstract

We reviewed six patients with cerebral hydatid embolism from the heart. Although hydatid disease is becoming less common in the world as a whole, it should be considered in the differential diagnosis of embolic stroke in children, especially in the infested areas where hydatidosis is endemic.

Hydatidosis of central nervous system and its coverings in the pediatric and adolescent age groups in Turkey during the last century: a critical review of 137 cases

“…Characteristically, there were no specific signs and the symptoms varied widely from patient to patient, depending on the location and type of the cystic lesion. Interestingly, 4 patients had been reported as "stroke victims" owing to embolization of echinococcal material [56,57,88,100,101,105] and 3 with the symptoms affecting the extrapyramidal system, as having a "movement disorder" because of the anatomical localizations of the cysts [35,43,47,81,85]. Other diagnostic studies, such as X-ray films, pneumoencephalography, ventriculography, angiography, scintigraphy, and electroencephalography, were used in patients with intracranial hydatid cysts in earlier years.…”

“…These generally reveal a characteristic round, well-defined unilocular cystic lesion containing fluid with absorption values similar to that of CSF [5,8,9,11,31,51,85,86,89,103,104,111]. Single cysts are found in the vast majority of patients, but multiple cysts can result from surgical, spontaneous, or traumatic rupture of a viable primary lesion [96,100,103]. Generally, they cause significant ventricular distortion and shifting of the midline structures.…”

“…In contrast to focal neurological signs, such as hemiparesis and epileptic seizure, in adults, in children and adolescents the clinical picture usually includes the cardinal symptoms of increased intracranial pressure (IICP): headache and vomiting are the most common. On the other hand, clinical manifestations related to movement disorders and occlusive cerebrovascular diseases are extremely uncommon [47,100,103].…”

“…In pediatric or adolescent patients with otherwise unexplained multiple intracranial hydatidosis, the possibility of arterial embolism should be considered [96,100,103]. Infratentorial intraventricular and brain stem hydatid cysts have occasionally been reported from Turkey, including 1 case in the fourth ventricle, 2 in the pons and 3 in the aqueduct of Sylvius [2,10,37,78,79,108].…”

“…In clinical practice, children with hydatid cysts of the CNS and its coverings are frequently seen by neurosurgeons, pediatric neurologists and spine surgeons, especially in agricultural parts of the world, and in these especially where sheep rearing is widespread. At present, it is one of the most important helminthic diseases in Turkey, as it is a serious cause of public health and economic problems [11,15,94,98,99,100,102,103].…”