2014 JOURNAL OF MEDICAL RESEARCHVol.1 No.1Vol.1Jul.–Dec. 2014ERA’S JOURNAL OF MEDICAL RESEARCHJul.–Dec. No.1ERA’S
SHORT COMMUNICATION
CEREBEllAR CYSTIC MASS CAUSING oBSTRUCTIVE
HYDRoCEPHAloUS
Karoli R2, Fatima J2, Shukla V1, Siddiqui Z1 Associate Professor1, Professor2,
Assistant Professor, Department of Medicine, Era’s Lucknow Medical College and Hospital, Lucknow India
A 60 year old gentleman from rural background presented
with history of worsening bifrontal headache, intractable Corresponding Author
vomitings and ataxic gait for last one month. All general Dr. Ritu Karoli
rofessor
and systemic examination was normal except neurological PDepartment of Medicine
examination which revealed cerebellar signs on right side Era’s Lucknow Medical
and bilateral papilloedema. The computerized tomography College and Hospital
rfarazganj, Hardoi road,
of brain revealed a large well defined, non–enhancing SaLucknow – 226003
multilocular cyst with internal septations and without Email–ritu.karoli@rediffmail.com
any perilesional oedema in right cerebellar region causing Telephone no–0522–2407824 no. 09415547894Fax
compression of fourth ventricle. The patients was referred
to neurosurgeon with a probable diagnosis of hydatid cyst
for excision of the cyst. During surgery the cyst got ruptured
and found to be filled with xanthochromic fluid and was
lined by white membrain.
Hydatosis infestation (caused by larvae of Echinococcus
granulosis) is a zoonotic disease, humans getting infected
accidentally as intermediate host. The disease is transmitted
usually by food–borne contamination by eggs passed in
faeces of definitive host, mainly dogs. The cysts preferentially
affect liver (in 50% cases) but may involve lungs, bone and
brain. The intracranial hydatid cysts are rare and constitute
only1–2% of all cases with hydatid disease. The hydatid cysts
are rare in adults particularly in the elderly population and Fig.1right cerebellarCT scan of region brain showing large hydatid cyst in
they are more common in paediatric age group. The location
of cyst was also unusual in this case as the intracranial cysts
are more frequently located in hemispheric parenchyma,
perfusion territory of middle cerebral artery specially
parietal lobe and also subarachnoid spaces.Hydatid cysts
are usually unilocular while in this case it was multilocular.
Laboratory diagnosis by ELISA, immunoblot and indirect
immunoflourescence assist in diagnosis but negative
serology does not rule out the disease. MR imagining is
more sensitive in demonstrating daughter cyst, CT is more
sensitive in depicting cyst calcification. The treatment of
ig.2 Histopathology slide showing brood capsules of E.granulosus
intracranial hydatid cyst is surgical and principal is to excise F
the cyst into without rupture, to prevent recurrence and REFERENCE
anaphylactic reaction.1. G upta S. Desai K. Goel A. Intracranial hydatid cyst: a report of
five cases and review of literature. Neurol India 1999; 47:214–220.
2. O sborn G. Preece M. Intracranial Cyst: Radio logic– pathologic
correlation and imaging approach. Radiology 2006;239(3):650–64.EJMR
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