Hilmani S, El Malki M, Bertal A, Achouri M, Sami A, Ouboukhlik A, El Kamar A, El Azhari A
Service de Neurochirurgie, CHU Ibn Rochd, Casablanca, Maroc.
Neurochirurgie. 2004 Mar;50(1):57-60. doi: 10.1016/s0028-3770(04)98307-5.
Hydatid disease is a serious public health problem in developing countries. Cerebrospinal localizations account for 1% of all cases of hydatid disease. The spino-radicular form is exceptional. We report a case of a 25-year-old women with cauda equina. Thoraco-lumbar MRI has showed an intradural process extending from L3 to L5, a low-intensity signal on T1 weighted images and a high-intensity signal on T2 weighted images, which were not enhanced after gadolinium injection. There was no vertebral involvement. After L3 L4 and L5 laminotomy and opening of the dura-matter, multiple vesicles were found scattered among the roots, with no adhesion to meninges or nervous structures. Total extirpation was easy. The outcome was marked by recovery of the motor deficit and sphincter disorders. This localization is serious but its prognosis is excellent if the diagnosis is made early enough to prevent cyst rupture and to allow total resection.
包虫病在发展中国家是一个严重的公共卫生问题。脑脊髓部位的包虫病占所有包虫病病例的1%。脊髓神经根型极为罕见。我们报告一例25岁患有马尾神经受累的女性病例。胸腰段磁共振成像显示硬膜内病变从L3延伸至L5，T1加权像呈低信号，T2加权像呈高信号，注射钆后无强化。无椎体受累。在L3、L4和L5椎板切开并打开硬脑膜后，发现多个囊泡散在于神经根之间，与脑膜或神经结构无粘连。完整摘除很容易。结果是运动功能障碍和括约肌功能障碍得以恢复。这种定位情况严重，但如果能尽早诊断以防止囊肿破裂并进行完整切除，其预后极佳。
