Hydatid Disease of the Central Nervous System; retrospective study of 20 cases.

Dr.M. Ramanjulu; Dr. C.Venkateswara Rao; Dr. M.L.Ananth; Dr.B.N.Nagaraju; Dr.G.Ram Balaji Naik

Volume : IV, Issue : VII, July - 2015

Hydatid Disease of the Central Nervous System; retrospective study of 20 cases.

Dr. M. Ramanjulu, Dr. C. Venkateswara Rao, Dr. M. L. Ananth, Dr. B. N. Nagaraju, Dr. G. Ram Balaji Naik,

Abstract :

 Objective: Hydatid disease primarily affects the liver; the secondary involvement due to hematogenous spread may be seen in almost any locations e.g.., lung, kidney, spleen, bone, and central nervous system. We aimed to assess clinical findings, radiological investigations and treatment of cases with central nervous system (CNS) hydatid cyst disease. Materials and method: the present study included 20 patients who were operated for CNS hydatid cysts disease from 1984– 2014. The clinical features, radiological investigations and treatment of cases are retrospectively analyzed and the pertinent literature is reviewed and compared the results with those reported in literature. Results: fourteen patients were male and six were female .The mean age of the study population was 20 years (range 10–50 years). All the patients came from rural areas .Headache and motor deficits were the most common clinical symptoms in patients with intracranial hydatidosis where as the back pain and spinal compression syndrome were most frequent clinical presentation in case of spinal hydatidosis. The lesion was demonstrated by computed tomography (CT) and magnetic resonance imaging (MRI) as large smooth thin walled spherical shaped cystic homogeneous lesions with same density as cereospinal fluid (CSF) which showed no edema or contrast uptake in intracranial hydatid cyst disease. The location of cysts was intracranial in 11 cases (55%), orbital 2(4%) and spinal in 7(14%) cases. Two patients were infected cysts. In all patients with intracranial, the cysts were removed completely with Dowling’s technique. All the spinal hydatid cysts are excised by doing laminectomy at the level of spinal involvement. Eight patients had ruptured cysts during operations. Recurrent or systemic hydatid cysts were treated medically. Pathological findings were consistent with hydatid cysts in all cases. During the follow up period which ranged from 5 months and 16 years, 8 had recurrence (40%). Conclusion Despite all the advances in imaging techniques and therapeutic methods ,CNS hydatidosis remains difficult to cure and the patient outcomes are not satisfactory especially in case of spinal involvement due to high incidence of recurrence.