Magnetic resonance imaging of simple and infected hydatid cysts of the brain
Introduction
Cerebral hydatid cysts are extremely rare forming only 2% of all intracranial space-occupying lesions even in countries in which the disease is endemic [1]. The cerebral hydatid cyst develops in soft tissues and grows without resistance, thus forming a single spherical vesicle which may reach a considerable size before declaring its presence clinically [2]. Cerebral hydatid cysts should be regarded as malignant because of their location and diagnosis is important [3], [4].
Several diagnostic methods have been employed, but CT provides definitive results. The exact location, size and number of hydatid cysts in the brain can be determined with CT scan [5]. MRI will come to be more widely used for diagnosis and surgical planning in cerebral hydatid disease. MRI shows details that cannot be seen on CT [6].
The CT findings of cerebral hydatid cysts have been described, but there has been little mention of the MRI findings. So, we planned for this work as an attempt to describe the MRI characteristics of simple and infected (complicated) cerebral hydatid cysts.
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Materials and methods
This study included 16 patients who were treated for intracranial hydatid cysts in, Dr. Ali Omar Askar, Neurosurgery Center, Tripoli, Libya. They were 11 male and 5 female patients ranging in age from 6 to 40 years, with an average age of 14.7 years. All patients were evaluated with CT scan and MRI of the brain. All lesions were surgically removed. Post-operative CT scan and MRI were done at varying intervals for follow-up.
Cerebral MRI examination of all patients were performed using a 0.5-T
Clinical findings
Most of the patients were children 12 patients out of 16 (75%) between 6 and 16 years of age (Table 1). Also there was a substantial prevalence of male patients-11 cases (68.75%). Headache was the predominant symptom (Table 2), followed in order of frequency by vomiting, seizures and visual disturbances. Papilloedema was seen in 12 patients (75%), positive Babinski sign was seen in 3 patients, other neurologic findings are shown in (Table 3).
Radiologic findings
MRI is the best method for diagnosis and surgical
Discussion
Hydatid disease is endemic in sheep-raising regions of the world, notably South America, New Zealand, Australia, the Middle East and the Mediterranean area [2]. In all series including ours, most of the patients with cerebral hydatid cysts were from rural areas.
The pathogen responsible for CNS hydatid disease is Echinococcus. Two species of Echinococcus may infect the human nervous system: E. granulosus and E. multilocularis. The two cestodes differ in life cycle, morphology and epidemiology.
Conclusion
CHCy is a cystic lesion which can appear mostly in children and young adults from countries where hydatid disease is endemic. Most of the cysts are located supratentorial, particularly in the left parietal lobe. All cysts are solitary. Although CT scanning has enormously improved the diagnosis, yet MRI has come to be more widely used in diagnosis and surgical planning in cerebral hydatid disease. MRI provides additional information and details that can not be seen by CT. It provides additional
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