Erşahin Y, Mutluer S, Dermirtaş E, Yurtseven T
Department of Pathology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
Clin Neurol Neurosurg. 1995 Nov;97(4):321-3. doi: 10.1016/0303-8467(95)00052-l.
Cerebral hydatidosis account for approximately 1-2% of patients with hydatid disease. Fifty percent to 75% of intracranial hydatid cysts are seen in children. The cerebral hydatid cysts are usually single and located in the watershed of the middle cerebral artery. To our knowledge, no case of hydatid cyst in the thalamic location has been reported. A 4-year-old boy presented with the left sided weakness. A right thalamic hydatid cyst without rim enhancement and perifocal oedema was detected on the computed tomographic (CT) scan. He was put on albendazole, but headache, nausea and vomiting developed and hemiparesis got worse in the following two weeks. The non-contrast repeat CT showed the pericystic oedema. The rim enhancement and pericystic oedema were also present on magnetic resonance imaging scans. The right thalamic hydatid cyst was removed via the transcallosal approach. The cyst aspiration and intracystic injection of hypertonic saline were performed before the cyst removal. Leakage of the cyst fluid was conceivably the cause of the development of rim enhancement and pericystic oedema. Patients receiving albendazole for the treatment of cerebral hydatid cysts should be closely followed. The surgery is still the choice of treatment in cerebral hybrid cysts, in our opinion.
脑包虫病约占包虫病患者的1% - 2%。50%至75%的颅内包虫囊肿见于儿童。脑包虫囊肿通常为单个，位于大脑中动脉的分水岭区。据我们所知，尚未有丘脑部位包虫囊肿的病例报道。一名4岁男孩出现左侧肢体无力。计算机断层扫描（CT）显示右侧丘脑有一个无边缘强化和灶周水肿的包虫囊肿。他接受了阿苯达唑治疗，但在接下来的两周内出现头痛、恶心和呕吐，偏瘫也加重。非增强重复CT显示囊肿周围水肿。磁共振成像扫描也显示有边缘强化和囊肿周围水肿。通过经胼胝体入路切除右侧丘脑包虫囊肿。在切除囊肿前进行了囊肿抽吸和囊内注射高渗盐水。囊肿液渗漏可能是边缘强化和囊肿周围水肿形成的原因。接受阿苯达唑治疗脑包虫囊肿的患者应密切随访。我们认为，手术仍是脑包虫囊肿的治疗选择。
