Intradural spinal hydatid cysts

Abstract

Spinal hydatid cysts are very rare and comprise only 1% of all bony involvement. Intradural hydatid cysts are extremely rare compared to other types of spinal hydatid cysts. We report the case of a 19-year-old man with lumbar intradural hydatid cysts. He complained of paraparesis and urinary hesitancy. Myelography revealed a block of the contrast medium at the L4 level and multiple round radiolucent lesions rostrally. At surgery, multiple hydatid intradural cysts were extirpated. The patient's neurologic deficits improved postoperatively, but recurred 6 weeks later. Reoperation led to partial improvement of deficits. Primary intradural hydatid cysts are extremely rare. It is difficult to explain an isolated intradural location of multiple cysts. In our patient, the cysts were multiple and the patient's cerebral CT scan was normal; he had undergone no previous lumbar puncture. So we can hypothesize that intradural spinal cysts may be primarily multiple.

Spinal echinococcosis: Review of the literature

“…Ranije je postojala sumnja da se zaista radilo o intramedularnoj ehinokokozi, što je naprednijom neuroradiološkom dijagnostikom potvrđeno u malom broju slučajeva [1][2][3][4][5][6][7] .…”

“…U kostima multiple ciste su pravilne i stvaraju se egzogenom vakuolizacijom-neka vrsta hernije germinativnog sloja membrane proligere kroz listove kutikularne membrane. Prema podacima iz literature redosled zahvaćenosti pojedinih segmenata kičmenog stuba je sledeći: cervikalni deo 10%, torakalni deo 50% (maksimalna incidenca Th12), lumbalni deo 20% i sakralni deo 20% (3,15).…”

Severe kyphoscoliosis after primary Echinococcus granulosus infection of the spine

“…Intraspinal echinococcosis appears only sporadically worldwide, whereas extradurally located cysts have been reported more frequently than intradurally ones [10,11]. If spinal hydatidosis causes clinical symptoms, they are initially non-specific and patients usually present with disease-associated complications.…”

“…This should be done before any surgical intervention already to prevent the patient from a potentially lethal anaphylactic shock in case of a rupture of an active cyst, where the lipoprotein antigens of the parasite are delivered [8,10,11,14,20]. Albendazole blocks glucose uptake and depletes the glycogen stores of the parasite.…”

Answer to the Letter to the Editor of F.-A. Dauchy et al. concerning manuscript “Intradural extramedullary primary hydatid cyst of the spine: a case report and review of literature”. Eur Spine J, doi:10.1007/s00586-012-2373-1 by I. Lotfinia, S. Sayyahmelli, A. Mahdkhah, M. Shoja M (2012)

“…Braithwaite and Lees have classified the spinal involvement by hydatid disease in five groups: (1) primary intramedullary hydatid cyst; (2) intradural extramedullary hydatid cyst; (3) extradural intraspinal hydatid cyst; (4) hydatid disease of the vertebrae; and (5) paravertebral hydatid disease. The first three types in this group are considered rare [19,20]. Recurrence is very rare with the intradural extramedullary form of hydatid disease [9,11].…”