Cerebral hydatid disease

Case contributed by Dr Ammar Haouimi

Presentation

History of chronic headaches, generalized epilepsy with low back pain. Cerebral and lumbar MRI was requested by his treating doctor.

Patient Data

Age: 30 years
Gender: Male
MRI

There is a well-defined unilocular ovoid cystic lesion centered on the left centrum semiovale, communicating through the midline with others lobulated multiseptated cystic lesions of extra-axial location in the right frontal region. These cystic lesions demonstrate a low signal on T1WI, high signal on T2WI with no peripheral enhancement or surrounding edema seen. A mass effect is noted on the midline structures. Note the involvement of the right frontal bone and adjacent subgaleal tissue.

MRI

The lumbar MRI (not shown) was unremarkable, but a cystic lesion was noted in the liver on the coronal sequence. This cystic lesion is located in the segment VIII and appears well-defined of low signal intensity on T1WI, high signal intensity on T2WI with detached membranes of low signal on T2WI.

MRI

This brain MR was performed three years after surgery (no surgical report available).

There is an artifact at the left frontal region in front of the craniotomy with a small area in the centrum semiovale of low signal on T1WI, high signal on T2WI with no enhancement (postoperative area).

Two contiguous extra-axial lobulated multiseptated cystic lesions are noted in the right anterior frontal region of low signal intensity on T1WI, high signal intensity on T2WI with no surrounding edema or peripheral enhancement is seen (the enhanced subarachnoid vessels should not be taken as enhancement). A thin rim of CSF "cleft sign" surrounding the lesions, well-visualized on T2WI, indicating their extra-axial location. A mass effect is noted on the midline structures with subfalcine herniation.

Case Discussion

Case of cerebral hydatid disease with recurrence three years after surgical resection.

Intracranial hydatid disease is very rare. Most of the cerebral hydatid cysts are located in the supratentorial compartment, usually in the middle cerebral artery territory. Both intra-and extra-axial locations are rarely described in the literature.

PlayAdd to Share

Case information

rID: 69258
Published: 5th Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.