Cystic lesions of the brain: Think of the hydatid cyst

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Ichrak Bougharriou
Emna Elleuch
Salma Ben Hmida
Ala Meddeb
Zaher Boudaouara
Brahim Kammoun
Mounir Ben Jemaa

Abstract

Background : Hydatidosis is an endemic parasitosis in Tunisia that affect mostly the liver and the lung. Brain involvment is rare.

Aim: To focus on diagnostic, therapeutic and evolutive characteristics of cerebral hydatidosis.

Methods : We report all cases of cerebral hydatidosis seen in the infectious diseases and neurosurgery departments between January 2013 and June 2020.

Results : Six cases of intracranial hydatid cyst were reported. The male to female ratio was 3:3. Age ranged from 3 to 60 years with a median age of 20,5 years. All patients lived in rural areas. The clinical symptomatology was progressive in 4 cases. It was dominated by headache (all cases). Brain imaging confirmed the diagnosis in all cases. The hydatid cyst was solitary and supratentorial in 3 cases. All the patients were operated. Albendazole was prescribed immediately after surgery, for 6 months in 5 cases and for 3 years in the case of disseminated hydatidosis. The outcome was favorable without recurrence in all patients with an average follow-up of 3,5 ± 0,5 years.

Conclusion : Hydatid cyst of the brain is characterized by the severity of the neurological signs, the mandatory use of surgery because of life threatening and the excellent outcomes.

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