Intracranial hydatid disease

Abstract

Background: Echinococcosis also known as hydatid disease is an endemic zoonotic disease with growing public health concern with an estimated financial burden of US Dollars 193,539,740 annually. Its definitive host being carnivores and man being an accidental intermediate host. The most common organ affected is the liver, the brain is involved in about 2% of cases. Intracranial hydatid carries high morbidity owing to pressure effect and a slow-growing hence the diagnosis is often delayed. Surgery is the mainstay of treatment, medical management being reserved for selected cases.
 Materials and method: A retrospective analysis of all the cases of intracranial hydatid disease managed at our department was done from 2013 to 2020 and data were analysed. 
 Results: A total of 6 cases were found with an incidence of 1.33% of all intracranial space-occupying lesions during the study period with male to female ratio of 5:1, mean age at presentation 21.2 years, 4 out of 6 patient in the pediatric age group, cyst localised mainly in middle cerebral artery territory, mostly solitary but multiple in one case, all cases managed surgically with preoperative rupture in one case, recurrence noted in another one, Albendazole was given to cases only with rupture or recurrence.
 Conclusions: Intracranial hydatid disease should be suspected in all non-enhancing cystic brain lesions especially in endemic regions and all patients should have preferably surgical excision using the “Dowling technique” with medical management reserved for inaccessible lesions, patients unfit for surgery, rupture and recurrent cases. Its high time when public health strategies should also be focussed on prevention and control of disease with appropriate measure at the community level.