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 »  Abstract
 »  Introduction
 »  Case report
 »  Discussion
 »  References

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Year : 2001  |  Volume : 49  |  Issue : 2  |  Page : 203-4

Primary spinal intradural hydatid cyst--a short report.


Department of Neurosurgery, Govt. Rajaji Hospital, Madurai, 625 020, India.

Correspondence Address:
Department of Neurosurgery, Govt. Rajaji Hospital, Madurai, 625 020, India.

  »  Abstract

Primary spinal hydatid cysts are uncommon. Among these, intradural presentation is very rare. A case of primary spinal intradural hydatid cyst presenting as incomplete dorsal cord compression is reported here for its rarity.

How to cite this article:
Pushparaj K, Sundararajan M, Madeswaran K, Ambalavanan S. Primary spinal intradural hydatid cyst--a short report. Neurol India 2001;49:203


How to cite this URL:
Pushparaj K, Sundararajan M, Madeswaran K, Ambalavanan S. Primary spinal intradural hydatid cyst--a short report. Neurol India [serial online] 2001 [cited 2021 Jun 20];49:203. Available from: https://www.neurologyindia.com/text.asp?2001/49/2/203/1261




   »   Introduction Top

Primary intraspinal hydatid cysts are uncommon.[1],[2],[3],[4],[5],[6],[7] Their intradural location is extremely rare. The case reported here, presented as dorsal cord compression due to hydatid cyst in the inradural extramedullary compartment.


   »   Case report Top

A 40 year old female presented with history of low back pain of 2 years duration and progressive weakness of both lower limbs of 6 months duration. There was no history of trauma, fever and contact with tuberculous patients. Patient had asymmetrical spastic paraparesis, right more than left. All modalities of sensation were impaired below D10 cord level. Deep tendon reflexes in both lower limbs were brisk. Plantars were bilaterally extensor. Bladder and bowel functions were normal. Spinal tenderness was present at D10-D11 levels. There was no gibbous. MRI of the dorsal region revealed complete obliteration of subarachnoid space opposite D10-D11 vertebra with evidence of cystic lesion in T1WI [Figure - 1]. In T2WI, contents appeared hyperintense [Figure - 2].
Laminectomy of D9-D12 was done. Dura was opened in midline, rostral to intradural cyst, and extended caudally. A small bunch of pearly white cystic masses was encountered; which was removed in toto. The appearance of the cyst suggested a hydatid cyst. The cord under the cyst was pale and compressed. Histopathological examination confirmed the diagnosis of hydatid cyst. The patient improved after surgery. A detailed clinical, serological radiological and ultrasonographic examination done post operatively did not reveal any evidence of hydatid cysts in other sites. At present, the patient is symptom free but for the local pain at the operated site. Patient was put on Tab. Mebendazole 400 mg twice a day.


   »   Discussion Top

Spinal hydatid cysts account for about 1% of all cases of hydatid disease.[1],[3] A hydatid cyst causing intradural cord compression was not suspected even after MRI. A strong possibility of arachnoid cyst was entertained preoperatively. Hydatid cyst is usually a single thin walled cyst with intensity of the contents being similar to that of CSF.[4],[5] Appearance of hypointensity in T1WI and hyperintensity in T2WI indicates viable cyst. The effects on the spinal cord are usually secondary to the vertebral involvement. Vertebral involvement is common as a result of provertebral shunts and the tendency of the parasite to grow easily in cancellous bone.[1] In the present case plain X-rays, MRI and operative exploration did not reveal any primary disease of the vertebral body.
The diagnosis of hydatid cyst should be considered for cystic lesions causing cord compression, however surgical exploration is confirmatory.

 

  »   References Top

1.Pamir MN, Akalan N, Ozgen t et al : Spinal hydatid cysts. Surg Neurol 1984; 21 : 53-57.   Back to cited text no. 1    
2.Sharma A, Kashyap V, Abraham J : Spinal intradural hydatid cyst. Surg Neurol 1981; 16 : 235-237.   Back to cited text no. 2    
3.Natarajan M : Hydatid disease. In : Textbook of Neurosurgery. Ramamurthy B (ed.) Vol. I, National Book Trust, India. 1980; 472-477.   Back to cited text no. 3    
4.Akhan O, Dincer A, Saalei I et al : Spinal intradural hydatid cyst in a child. BJR 1991; 64 : 465-466.   Back to cited text no. 4    
5.Tekkoki H, Benli L : Primary spinal extradural hydatid disease. Report of a case with magnetic resonance. Characteristic and Pathological correlation. Neurosurgery 1993; 33 : 320-322.   Back to cited text no. 5    
6.Islekel S, Zileti M, Ersahin Y : Intradural spinal hydatid cysts. European Spine Journal 1998; 7 : 162-164.   Back to cited text no. 6    
7.Mathuriya SN, Arora OP, Khosla VK et al : Infected intradural hydatid cyst at foramen magnum. Clin Neurol Neurosurg 1985; 87 : 283-286.   Back to cited text no. 7    

 

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