CLINICAL FEATURES AND OUTCOME ANALYSIS OF INTRACRANIAL HYDATID CYSTS

Authors

  • Muhammad Mukhtar Khan Department of Neurosurgery, Hayatabad Medical Complex Peshawar
  • Mewat Shah Department of Neurosurgery, Hayatabad Medical Complex Peshawar
  • Abdul Aziz Khan Ayub Medical College, Abbottabad
  • Riaz ur Rehman Gaju Khan Medical College, Swabi
  • Shahid Ayub Department of Neurosurgery, Hayatabad Medical Complex Peshawar
  • Ayaz Ahmad Department of Neurosurgery, Hayatabad Medical Complex Peshawar
  • Atif Aman Department of Neurosurgery, Hayatabad Medical Complex Peshawar
  • Muhammad Ali Shah Department of Neurosurgery, Hayatabad Medical Complex Peshawar

Abstract

Background: Hydatid cyst of the brain is a serious zoonotic parasitic infection which have profound health consequences if left untreated. The surgical excision of the cysts are rewarding for both the patient the neurosurgeon. Methods: The study was conducted prospectively at Department of Neurosurgery Hayatabad Medical Complex Peshawar from January 2013 to December 2014. Patients with a diagnosis of intracranial hydatid cysts were included, clinical and radiological features recorded, intervention and postoperative outcome were analysed. Results: Eleven patients with a male to female ratio of 1.7:1. Mean age was 12.4 (SD±6.5) years with median GCS on arrival of 10 (SD±2.5). Clinical features were headache (81.8%), vomiting (90.9%), seizures (36.4%), focal deficits (54.5%) and papilloedema (72.7%). The median GCS on discharge was 13 (SD±1.1) while GOS at 1 month follow up was 4 (SD±0.7). The bivariate analysis showed inverse correlation (R2=-0.68; p=0.02) between duration of symptoms and outcome while GCS on admission was positively correlated (rs=0.75; p=0.007) with the outcome. There was no mortality. Conclusion: Despite its rarity the clinical features are non-specific while radiological features help in establishing diagnosis. Earlier diagnosis and prompt intervention is the key to favourable outcome.

References

Dandan IS, Soweid AM, Abiad F. Hydatid cysts clinical presentation. Emedicine. [Internet]. [cited 2015 Apr 2]. Available from: http://emedicine.medscape.com/article/178648-clinical

Tapia EO, Vidal TA, Antonio PL. Brain hydatidosis: report of four cases. Rev Med Chil 2012;140(3):358–63.

Taratuto AL, Venturiello SM. Trichinosis. Brain Pathol 1997;7(1):663–72.

Wani NA, Kousar TL, Gojwari T, Robbani I, Singh M, Ramzan A, et al. Computed tomography findings in cerebral hydatid disease. Turk Neurosurg 2011;21(3):347–51.

Osborn AG, Preece MT. Intracranial cysts: radiologic-pathologic correlation and imaging approach. Radiology 2006;239(3):650–64.

Umerani MS, Abbas A, Sharif S. Intra cranial hydatid cyst: A case report of total cyst extirpation and review of surgical technique. J Neurosci Rural Pract 2013;4(Suppl 1):S125–8.

Lakhdar F, Arkha Y, Bougrine M, Derraz S, El Ouahabi A, El Khamlichi A. Posterior fossa extradural and extracranial hydatid cyst. Neurochirurgie 2010;56(5):391–4.

Tsitouridis J, Dimitriadis AS, Kazana E. MR in cisternal hydatid cysts. AJNR Am J Neuroradiol 1997;18(8):1586–7.

Duransoy YK, Mete M, Barutcuoglu M, Unsal UU, Selcuki M. Intracranial hydatid cyst is a rare cause of midbrain herniation: A case report and literature review. J Pediatr Neurosci 2013;8(3):224–7.

Zhang W, Wen H, Li J, Lin R, McManus DP. Immunology and immunodiagnosis of cystic echinococcosis: An update. Clin Dev Immunol 2012;2012:101895.

Reddy DR. Managing cerebral and cranial hydatid disease. Neurol India 2009;57(2):116–8.

Krajewski R, Stelmasiak Z. Cerebral hydatid cysts in children. Childs Nerv Syst 1991;7(3):154–5.

Duishanbai S, Jiafu D, Guo H, Liu C, Liu B, Aishalong M, et al. Intracranial hydatid cyst in children: Report of 30 cases. Childs Nerv Syst 2010;26(6):821–7.

Ali M, Mahmood K, Khan P. Hydatid cysts of the brain. J Ayub Med Coll Abbottabad 2009;21(3):152–4.

Wang J, Cai B, You C. Surgical treatment options for cerebral alveolar echinococcosis: experience in six patients. Neurol India 2009;57(2):157–61.

Hariharan U, Garg R, Gupta A, Wasnik S, Pawar M. Anaesthetic concerns for large intracranial cyst excision: expect the unexpected! Clin Pract 2012;2(2):e50.

Nourbakhsh A, Vannemreddy P, Minagar A, Toledo EG, Palacios E, Nanda A. Hydatid disease of the central nervous system: a review of literature with an emphasis on Latin American countries. Neurol Res 2010;32(3):245–51.

Najjar MW, Rajab Y, El-Beheiri Y. Intracranial hydatid cyst. Dilemma in diagnosis and management. Neurosciences (Riyadh) 2007;12(3):249–52.

Todorov T, Vutova K, Petkov D, Balkanski G. Albendazole treatment of multiple cerebral hydatid cysts: case report. Trans R Soc Trop Med Hyg 1988;82(1):150–2.

Ciurea AV, Fountas KN, Coman TC, Machinis TG, Kapsalaki EZ, Fezoulidis NI, et al. Long-term surgical outcome in patients with intracranial hydatid cyst. Acta Neurochir (Wien) 2006;148(4):421–6.

Duishanbai S, Geng D, Liu C, Guo HR, Hao YJ, Liu B, et al. Treatment of intracranial hydatid cysts. Chin Med J (Engl) 2011;124(18):2954–8.

Behari S, Banerji D, Phadke RV, Shukla S, Krishnani N, Chhabra DK. Multiple infected extradural parasellar hydatid cysts. Surg Neurol 1997;48(1):53–7.

Published

2016-03-10

Issue

Vol. 28 No. 1 (2016): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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