Ait Ben Ali S, Hilmani S, Choukri M, Sami A, El Azhari A, Achouri M, Ouboukhlik A, El Kamar A, Boucetta M
Service de Neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc.
Neurochirurgie. 1999 Dec;45(5):426-9.
The hydatic cyst is a pathology observed in developing countries. Multiple cerebral localizations with a cardiac origin are exceptional and are sometimes diagnosed only after onset of complications. We present the case of a 22-year-old male student: the diagnosis of multiple cerebral hydatic cysts caused by rupture of a cardiac hydatic cyst was established after an episode of ischemia of the limbs with cerebral hemorrhage induced by heparin. One year later, the clinical situation consisted in intracranial hypertension, hemiplegia and convulsive seizures. We observed no cardiac symptoms. The brain CT showed 9 hydatic cysts and echocardiography showed a myxomatous cystic tumor. Abdominal CT detected renal and splenic hydatic cysts. The patient underwent total ablation of the cerebral and abdominal cysts and made a full recovery. After surgical removal of the cardiac cyst, the patient has been lost to follow-up. Cerebral hydatidosis of cardiac origin is highly exceptional and, due to nonspecific symptomatology, may go undiagnosed. In general, prognosis is good in case of a cerebral localization but the cardiac localization is associated with high mortality.