Bakhsh Ahmed, Siddiqui Khalid Mukarram Ali, Taraif Suad
Department of Neurosurgey, Saad Specialist Hospital, Al-Khobar, Kingdom of Saudi Arabia.
Consultant Neurosurgeon and Assiststant CMO, Rayyan Hospital, SHG, Riyadh, KSA.
Asian J Neurosurg. 2017 Apr-Jun;12(2):314-317. doi: 10.4103/1793-5482.146397.
Preoperative diagnosis of cerebral echinococcosis in an unusual location is always difficult. Nonetheless, this possibility should be kept in mind in all cystic lesions of the brain. Although total excision of the cyst without rupture is a time - tested treatment, but in order to prevent recurrence, adjuvant medical treatment should also be started. Albendazole, mebenadazole and praziquental are commonly used drugs. Albendazole is a drug of choice. Its usual dose for adults is 400 mg twice daily. Exact duration of treatment is still uncertain, but it should not be <6 months. This case report shows primary presentation of hydatid cyst in the pineal region which later disseminated intracranially. However complete excision of the cyst at site of recurrence, combined with medical treatment, proved quite successful. Patient was found recurrence free 3 years after surgery. Last but not least, endoscopic third ventriculostomy and biopsy should be performed very carefully in cystic lesions of posterior third ventricular region.
术前诊断位于不寻常部位的脑包虫病总是很困难。尽管如此，对于所有脑部囊性病变都应考虑到这种可能性。虽然完整切除囊肿且不破裂是经过时间检验的治疗方法，但为了防止复发，还应开始辅助药物治疗。阿苯达唑、甲苯达唑和吡喹酮是常用药物。阿苯达唑是首选药物。其成人常用剂量为每日两次，每次400毫克。确切的治疗持续时间仍不确定，但不应少于6个月。本病例报告显示松果体区的包虫囊肿最初出现，随后在颅内播散。然而，在复发部位完整切除囊肿并结合药物治疗，结果相当成功。患者术后3年未发现复发。最后但同样重要的是，对于第三脑室后部区域的囊性病变，应非常谨慎地进行内镜下第三脑室造瘘术和活检。
