Turkey is an endemic country to hydatid disease. The definite hosts of echinococcus are various carnivores, the common being the dog. Neurohydatosis is a rare presentation and primary cerebral involvement is even rarer. Intracranial cases become symptomatic depending on location, size and growth rate of the cyst. This is an interesting case of asymptomatic primary hydatid cyst diagnosed after a traffic accident.
Hydatid cyst, Echinococcus, Neurohydatosis
An 8-year-old boy who was living in countryside, was brought to ER because of vomiting due to head trauma. His neurological examination was normal. CT scan revealed a cystic lesion in right parieto-occipital region with approx. 5 cm diameter (Figure 1). By cranial MRI large cystic lesion with periferal enhancement was detected (Figure 2). Indirect hemagglutination was negative. Before surgery, 15 mg/kg/d albendazole treatment was administrated. Further examinations revealed no other involvement in body. Right parieto‑occipital craniotomy performed and lesion was totally excised. Post-operative recovery was uneventful. In pathological examination, fibrous wall was excised and smooth semi-transparent hydatid cyst was seen (Figure 3). Albendazole treatment was continued. Cranial MRI at the post-op 2nd month revealed no pathological findings (Figure 4).
Albendazole is the first choice in hydatid disease but the primary treatment of intracranial hydatid cysts is surgery . Primary cerebral hydatid cyst rarely occurs in pediatric population. In endemic countries hydatid cyst presentations may be more various than usual . Specific radiological features play an important role in diagnosis of cerebral hydatid cases [1,2].
The abstract of the manuscript was accepted as an "e-poster presentation" at: The 34th Annual Meeting of the European Society for Paediatric Infectious Diseases, ESPID 2016, Brighton/UK. 10-14 May 2016.