Hydatidosis of the Brain
Cerebral hydatidosis is a rare parasitic disease representing only 1–2 % of all cerebral space-occupying lesions. It is still a major health problem in infected areas of the world, especially in rural areas. The vast majority of patients affected are chil
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Hydatidosis of the Brain Faten Limaiem and Nidhameddine Kchir
Contents
Primary and Secondary Hydatidosis
Primary and Secondary Hydatidosis ...................
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Diagnostic Approach.............................................. Epidemiological Data............................................... Clinical Data ............................................................ Biological Diagnosis ................................................ Imaging Diagnosis ...................................................
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Treatment ................................................................
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Conclusion ..............................................................
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References ...............................................................
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F. Limaiem, MD (*) Department of Pathology, Mongi Slim Hospital, La Marsa, Tunis 2046, Tunisia e-mail: [email protected] N. Kchir, MD Department of Pathology, La Rabta Hospital, Tunis, Tunisia
Hydatid disease of the brain is a rare parasitic infestation which constitutes only 1–2 % of all intracranial space-occupying lesions (Mingde and Zheshang 1981; Micheli et al. 1987; Demir et al. 1991; Ciurea et al. 2006). Children are much more frequently affected than adults. In fact, 50–93 % of intracranial cysts are found in children younger than 17 years (Ciurea et al. 2006). In a previous study, this percentage was even higher, reaching 95.7 % (Ciurea et al. 2006). Characteristically, there is a predominance of males and children (Table 6.1) because these groups associate more closely with animals than do females and adults. In the meta-analysis of Turgut (2001), there were 67 male (56 %) and 52 female (44 %) patients. Conversely, in some series of brain hydatidosis (Tlili-Graiess et al. 2006; Ali et al. 2009), there was a slight female predominance. It has been suggested that an underlying ductus arteriosus patency during the neonatal period may be a cause of increased vulnerability of children by allowing passage of the parasites from the periphery to the brain (Lunardi et al. 1991; Onal et al. 2006). In humans, intracranial hydatidosis can be associated with involvement of other organs such as liver or lung, or it may be an isolated infestation of the brain. Only embryos which succeed in passing through the filtering barrier systems in the liver and lung reach the brain by the systemic circulation. Once the hexacanth embryo has reached the brain, it will form a hydatid cyst
M. Turgut (ed.), Hydatidosis of the Central Nervous System: Diagnosis and Treatment, DOI 10.1007/978-3-642-54359-3_6, © Springer-Verlag Berlin Heidelberg 2014
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F. Limaiem and N. Kchir
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Table 6.1 Epidemiological characteristics of brain hydatidosis reported in some series between 1999 and 2012 Author(s) Gupta et al. Khaldi et al. Bükte et al. Ciurea et al.
Year 1999 2000 2004 2006
Number of cases 5 117 18 76
Sex ratio (M:F) 3:2 Slight male predominance 2:1 45:31
Tlili-Graiess et al. Ali et al. Duishanbai et al. Basraoui et al. Mohindra et al.
2006 2009 2010 2010 2012
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