Yaka Umut, Aras Yavuz, Aydoseli Aydın, Akcakaya Mehmet Osman, Sencer Altay, Imer Murat, Hepgul Kemal
Istanbul University, Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2013;23(4):505-8. doi: 10.5137/1019-5149.JTN.5826-12.1.
Hydatid disease is a life-threatening parasitic infestation caused by Echinococcus granulosus. Infection with E. granulosus typically results in the formation of hydatid cysts in liver, lungs, kidney and spleen. Majority of the intracranial cysts are secondary and solitary. Multiple primary cerebral cysts are uncommon. Surgical and medical management of a 14-year-old boy with multiple primary hydatid cysts are presented. 14 cysts, which were symptomatic due to their mass effect, were surgically removed, whereas a deep-seated asymptomatic cyst was followed-up with medical treatment. Despite proper antibiotic regimen the patient was admitted with epileptic seizures six months later. The deep-seated lesion was also surgically removed. Intraoperative observations and pathological examination demonstrated different characteristics, with pericystic gliosis, gel-like cyst content and death scolices within the cavity. In addition to the fact, that the presented case is an additional example for the rare primary multiple cerebral hydatid cysts, to our knowledge it is the first case of a dead cerebral hydatid cyst, causing symptoms despite effective medical treatment.
包虫病是一种由细粒棘球绦虫引起的危及生命的寄生虫感染。感染细粒棘球绦虫通常会导致肝脏、肺、肾脏和脾脏形成包虫囊肿。大多数颅内囊肿是继发性的且为单发。多发性原发性脑囊肿并不常见。本文介绍了一名患有多发性原发性包虫囊肿的14岁男孩的手术及药物治疗情况。14个因占位效应出现症状的囊肿通过手术切除，而一个深部无症状囊肿则采用药物治疗并进行随访。尽管采用了适当的抗生素治疗方案，但患者在6个月后因癫痫发作入院。深部病灶也通过手术切除。术中观察和病理检查显示出不同特征，包括囊周胶质增生、凝胶状囊内容物以及囊腔内死亡的头节。除了该病例是罕见的原发性多发性脑包虫囊肿的又一实例外，据我们所知，这是首例尽管经过有效药物治疗仍出现症状的死亡性脑包虫囊肿病例。
