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Review
. 2023 Mar;39(3):751-758.
doi: 10.1007/s00381-022-05770-7. Epub 2022 Nov 29.

Hydatid disease of the brain and spine

L C Padayachy  1 , M M Ozek  2
Affiliations
Review

Hydatid disease of the brain and spine

L C Padayachy et al. Childs Nerv Syst. 2023 Mar.

Abstract

Hydatid disease of the central nervous system is relatively rare and comprises about 2-3% of all the hydatid cyst cases reported in the world. Spinal hydatid disease is an even rarer entity. It is endemic in sheep and cattle-raising regions, seen mainly in Mediterranean countries including Turkey and Syria. Pediatric neurosurgeons in non-endemic countries face a challenge when they encounter children with hydatid cysts of the central nervous system, mostly due to lack of awareness and the ensuing diagnostic dilemmas. It is also a significant socioeconomic problem in developing countries, due to improper hygiene and lack of dedicated veterinary practice. The clinical features are largely nonspecific and very according to location and severity of disease. However, with the advent of advances in MR imaging, the diagnostic accuracy of hydatic disease involving the brain and spine has increased. Intact removal of the cyst/s, without causing any spillage, and appropriate antihelminthic therapy is the goal and key to cure and prevention of recurrence. In this manuscript, the current literature on hydatid cyst of the brain and spine is reviewed to better understand the epidemiology, pathophysiology, diagnostic accuracy, and advances in therapeutic options. A heightened clinical suspicion, awareness of MR imaging features, improved surgical strategies, and options for prevention are discussed.

Keywords: Echinococcus; Hydatid disease; Intracranial infestation; Spinal infection.

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Conflict of interest statement

The authors have no conflict of interest or funding to declare for this manuscript.

Figures

Fig. 1
Fig. 1
Calcified adventitial membrane
Fig. 2
Fig. 2
Axial CT scan demonstrating a large hydatid cyst in the left frontal hemisphere with irregular cyst wall
Fig. 3
Fig. 3
Dowliing's technique used to remove an intact hydatid cyst
Fig. 4
Fig. 4
Intra-operative microsurgical dissection to remove a large hydatid cyst
Fig. 5
Fig. 5
Intact hydatid cyst demonstrating exocyst membrane
Fig. 6
Fig. 6
Large hydatid cyst post-evacuation
Fig. 7
Fig. 7
a Sagittal T2-MRI demonstrating a cystic (neuroepithelial cyst) lesion ventral to the brainstem and spinal cord. b Post-operative sagittal T2-MRI demonstrating evacuation of the cyst decompression of the cord
See this image and copyright information in PMC

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