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Table of Contents    
Year : 2021  |  Volume : 69  |  Issue : 4  |  Page : 1111

Ruptured Brain Hydatid Cyst

Dr. Gulati Imaging Institute, J -16, Hauz Khas, New Delhi, India

Date of Submission18-Jun-2018
Date of Decision20-Mar-2020
Date of Acceptance15-May-2021
Date of Web Publication2-Sep-2021

Correspondence Address:
Parveen Gulati
Dr. Gulati Imaging Institute, J -16, Hauz Khas, New Delhi - 110016
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.325350

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How to cite this article:
Gupta LK, Mirza A, Gulati A, Gulati P. Ruptured Brain Hydatid Cyst. Neurol India 2021;69:1111

How to cite this URL:
Gupta LK, Mirza A, Gulati A, Gulati P. Ruptured Brain Hydatid Cyst. Neurol India [serial online] 2021 [cited 2021 Oct 23];69:1111. Available from:

A 3-year-old male presented to the neurology unit with complains of sudden onset of headache for two days. Neurological evaluation revealed mild motor weakness in right upper and lower limb. Magnetic resonance imaging brain revealed a large well-defined intraaxial cystic mass in the left frontal lobe with smooth undulating margins and marked surrounding edema [Figure 1]a, [Figure 1]b, [Figure 1]c. The lesion showed peripheral enhancement with no diffusion restriction [Figure 1]d and [Figure 1]e. Small intraluminal cysts were seen along the wall with double-layered appearance [Figure 1]f. The radiological diagnosis of ruptured hydatid cyst was confirmed on surgery.
Figure 1: (a and b) Axial T2W and T1W image shows intraaxial CSF isointense cystic lesion in the left frontal lobe with smooth undulating margins and marked surrounding edema. (c) Sagittal T2W image shows marked edema around the cystic lesion. (d) Post contrast images reveal peripheral contrast enhancement. (e) No diffusion restriction is seen on DWI images. (f) The magnified T2W image shows the intralesional small cyst (arrow) with multilayered wall

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Cerebral hydatid cyst is caused by Echinococcus granulosus that gets hematogenously transmitted to brain. The smooth undulating wall, daughter cysts, and multilayered appearance help in clinching the diagnosis. Perilesional edema signifies either the rupture of cyst or secondary infection. Surgical management is done with the removal of the cyst using Dowling's maneuver,[1] or puncture and aspiration of the cystic contents. Surgery is the treatment of choice for the cerebral hydatid cyst. However, in inoperable cases due to location and multiplicity, antihelminth medication is the only effective treatment. Albendazole is the better medication owing to its better resorption. It is administered orally at the dosage of 10–15 mg/kg/day.[2],[3] A study has also shown treatment by administrating Albendazole in high dosage of 17 mg/kg/day for 18 months.[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Carrea R, Dowling E Jr, Guevara JA. Surgical treatment of hydatid cysts of the central nervous system in the pediatric age (Dowling's technique). Childs Brain 1975;1:4-21.  Back to cited text no. 1
Stauga S, Schmiedel S. Inoperable cerebral alveolar echinococcosis controlled with high dosages of albendazole adjusted with monitoring of blood levels. J Travel Med 2012;19:198-201. 10.  Back to cited text no. 2
Brunetti E, Kern P, Vuitton DA, Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop 2010;114:1-16.  Back to cited text no. 3
Chen S, Li N, Yang F, Wu J, Hu Y, Yu S, et al. Medical treatment of an unusual cerebral hydatid disease. BMC Infect Dis 2018;18:12.  Back to cited text no. 4


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