A Rare Parasitic Infection: Primary Intradural Extramedullary Hydatid Cyst.

Echinococcus granulosus infrequently induces spinal hydatid cysts, and intradural hydatid cysts are extremely rare among these spinal hydatid cysts. We report a 30-year-old man with a history of progressive back pain caused by a previous back injury. Magnetic resonance imaging revealed a spinal intradural cystic lesion. After surgical removal, histopathological diagnosis was a hydatid cyst. The patient had no other symptoms of systemic hydatid cyst disease. Diagnosis of hydatid cyst should be considered prior to surgery, especially in young patients with spinal intradural cystic lesions, as leakage of the hydatid cyst's fluid during surgery is a frequent case of recurrence.

Spinal intradural extramedullary hydatidosis: report of three cases.

OBJECTIVE: Spinal hydatid cyst is a serious form of hydatid disease affecting fewer than 1% of all patients with hydatid disease. We report 3 healthy patients who presented with progressive paraparesis attributed to a histologically proven intradural hydatid cyst. METHODS: There were 2 children (1 boy, 1 girl) and 1 adult with a mean age of 12 years. The median follow-up duration was 16 months. Spinal magnetic resonance imaging was performed in the 3 patients, and an anatomic and topographical diagnosis of the intradural hydatid cyst was made. RESULTS: Magnetic resonance imaging scans revealed cystic lesions with peripheral contrast enhancement. Surgery was performed through laminectomy, complete resection was achieved, and antihelminthic treatment with albendazole 10 mg/kg-1 per day for 6 months was included in the postoperative treatment. The patients improved after surgery with normal motor function. CONCLUSION: This localization is rare and serious, but its prognosis is excellent if diagnosis is made early enough and surgery is performed in time to prevent cyst rupture.

Intradural dirofilariasis mimicking a Langerhans cell histiocytosis tumor.

We report the case of a 6-year-old female who presented a cervical intradural extra-spinal tumor, initially considered as a Langerhans cell histiocytosis. Additional histological slides revealed a Dirofilaria repens dirofilariasis. The particularity of this case is the intradural location of this filariasis, which usually has a subcutaneous or conjunctival location in human.

Multiple intradural spinal hydatid disease: a case report and review of literature.

STUDY DESIGN: A case report. OBJECTIVE: We present an unusual case of pathologically confirmed multiple distinct spinal intradural extramedullar spinal hydatid cyst after 1 year of lung cyst hydatid operation. SUMMARY OF BACKGROUND DATA: Hydatid disease is usually diagnosed in endemic regions. Spinal involvement of disease is very unusual and the literature about this entity is generally restricted to regional publications. Furthermore, intradural multiple involvement was not reported in literature. METHODS: A 14-year-old boy admitted to our clinic with pain in the back, both of leg and disability in walking. The patient presented with back pain, asymmetrical paraparesis, right more than left and weakness. Multiple distinct spinal intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be hydatid cyst by histopathologic confirmation after the surgical removal. RESULTS: T5 and L4, L5, S1 laminectomies were performed at the same session, after these a lot of pearly white hydatid cysts located intradural extramedullary were removed totally with their capsule, and the cavity was irrigated with 20% hypertonic saline. Surgical treatment was uneventful. Second-month follow-up neurologic examination was normal and the hydatid cysts had totally disappeared in both regions in the second month of postoperative magnetic resonance imaging. CONCLUSION: Spinal hydatid disease are uncommon. Among these, multiple distinct spinal intradural extramedullar location is extremely rare. Although total removal of the cysts without rupture should be the surgical goal in all cases, the best treatment remains an active nationwide prevention of the disease.

Cranial epidural hydatid cysts: clinical report and review of the literature.

BACKGROUND: Cerebral hydatidosis accounts for approximately 1-3% of all cases of hydatid disease. METHOD: In this report, 32-year-old female with epidural multilocular hydatid cysts in the midline posterior parietal region is reported. FINDINGS: Most commonly, cerebral hydatid cysts are single lesions and locate in the watershed of the middle cerebral artery. CONCLUSIONS: However, cerebral epidural hydatid cysts seem to have a tendency occurring around in the highly vascularized venous sinus.

[Unusual localization of spinal hydatid cyst]. / Localisation rare du kyste hydatique intra dural au niveau de la fosse posterieure.

We report one case of uncommon spinal hydatid cysts particular by its localization. It is intradural, localized with predilection in the big cistem cerebello-medullar. There is no involvement of adjacent vertebral discs and ligaments. We specify characteristic imaging features and polymorphism of this affection who can affect all anatomical structures. We emphasize MRI for diagnosis and follow-up in search for residual or recurrent lesions.

Primary intradural extramedullary hydatid cyst.

Spinal hydatid cysts account for 1% of all cases of hydatid disease; primary intradural hydatid cysts are uncommon. We present a case of pathologically confirmed intradural spinal cyst hydatid in an otherwise healthy patient who showed no other evidence of systemic hydatid cyst disease. The patient presented with back pain, paraparesis, and weakness. An intradural extramedullary cystic lesion was identified with magnetic resonance imaging and was shown to be a hydatid cyst by histopathologic examination after surgical removal. To our knowledge, this is the 25th case of hydatid cyst at an intradural extramedullary location reported in the literature.

Meningeal worm in deer from western Nebraska.

One hundred seventy-eight white-tailed deer (Odocoileus virginianus) and 275 mule deer (Odocoileus hemionus) collected from locker plants in the western 2/3 of Nebraska (USA) in November 1997 were examined for the meningeal worm (Parelaphostrongylus tenuis). Parelaphostrongylus tenuis was identified in 17 (10%) of 168 white-tailed deer and in one (<1%) of 273 mule deer. This is the first naturally occurring infection of P. tenuis recorded in a mule deer.

[Isolated lumbar intradural hydatid cyst]. / Kyste hydatique intradural lombaire isolé.

Intradural hydatidosis is a very uncommon form of vertebrospinal hydatidosis. We report a intradural lumbar localization, presenting the magnetic resonance imaging findings. We emphasize MRI for diagnosis and follow-up in search for residual or recurrent lesions.

Intradural spinal hydatid cysts.

Spinal hydatid cysts are very rare and comprise only 1% of all bony involvement. Intradural hydatid cysts are extremely rare compared to other types of spinal hydatid cysts. We report the case of a 19-year-old man with lumbar intradural hydatid cysts. He complained of paraparesis and urinary hesitancy. Myelography revealed a block of the contrast medium at the L4 level and multiple round radiolucent lesions rostrally. At surgery, multiple hydatid intradural cysts were extirpated. The patient's neurologic deficits improved postoperatively, but recurred 6 weeks later. Reoperation led to partial improvement of deficits. Primary intradural hydatid cysts are extremely rare. It is difficult to explain an isolated intradural location of multiple cysts. In our patient, the cysts were multiple and the patient's cerebral CT scan was normal; he had undergone no previous lumbar puncture. So we can hypothesize that intradural spinal cysts may be primarily multiple.

[A case of aspergillosis presenting marked granulomatous pachymeningitis].

The authors report a rare case of intracranial aspergillosis presenting marked granulomatous pachymeningitis. A 58-year-old male who had a three-year history of diabetes and chronic bronchitis was referred to us because of progressive left hemiparesis and dysarthria. Postcontrast CT scan showed a ring-enhancing lesion with marked perifocal edema in the right parietal lobe, and right subdural enhancing mass. MR image revealed hypertrophic dura mater in the right convexity. On June 9, 1992, partial removal of the intra-axial cystic mass and granulomatous dura mater was performed. A number of characteristic aspergillus hyphae were recognized in the resected cyst and granulomatous dura mater. Postoperatively, the patient was treated with amphotericin-B and fluconazole. But granulomatous pachymeningitis became progressively enlarged and eventually created a large mass effect again. On January 23, 1993, the patient died of pneumonia. Cerebral aspergillosis is getting common but preoperative diagnosis is still difficult because of its causing several clinical features such as brain abscess, granuloma, intracerebral hemorrhage, cerebral infarction, meningitis, and encephalitis. Several comments were made about the pathogenesis of these features, and the necessity of early diagnosis and treatment was emphasized.

Intracranial alveolar echinococcosis: CT and MRI.

Intracranial alveolar echinococcosis is uncommon. We report a patient with right frontal lobe and palpebral lesions secondary to a primary hepatic focus with secondary lesion in the lung. The intracranial and palpebral cystic masses were totally removed and both proved to be alveolar hydatid cysts. An unusual feature in this case is CT and MRI demonstration of dural and bony extension.

Parelaphostrongylus tenuis (Nematoda) in white-tailed deer (Odocoileus virginianus) in central Iowa.

Heads of hunter-killed white-tailed deer (Odocoileus virginianus) were obtained from a tri-county area in central Iowa in December 1991 and examined for the presence of Parelaphostrongylus tenuis (Dougherty, 1945). Adults of P. tenuis were found in 45% of 42 deer heads; the mean intensity of infection was 3.6 (range: 1-16). Prevalence of infection was significantly greater in female deer > 13 mo of age in comparison to males of similar age (54 vs. 17%). Mean intensity of infection was significantly greater in deer > 13 mo of age than in younger deer (4.4 vs. 1.2 nematodes/head). Both prevalence and intensity of P. tenuis infection in deer in Iowa were comparable to levels reported elsewhere in the United States and Canada. These results further define the distribution of P. tenuis and suggest that susceptible hosts sharing habitat with white-tailed deer in Iowa are at risk of infection with this parasite.