Outcome and Follow-up of Patients with Cerebral Hydatidosis
This chapter describes the outcome of treatment of cerebral hydatid disease which depends upon many factors such as the species of echinococcal infestation, whether it is primary or secondary, single or multiple; the anatomical location of the lesions in
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Deme Raja Reddy
Contents
Introduction
Introduction ............................................................
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Species of Echinococcal Infestation ......................
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Primary or Secondary ...........................................
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Solitary or Multiple................................................
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Unusual Locations..................................................
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Laboratory Diagnosis of Echinococcosis .............
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Treatment................................................................ Surgical Treatment ................................................... Medical Treatment ...................................................
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Hydatid Disease in Other Parts of the Body........
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Delayed Complications ..........................................
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Outcome and Prognosis of Hydatid Disease Involving the Central Nervous System .................
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Conclusion ..............................................................
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References ...............................................................
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D.R. Reddy, MD, MBBS, FRCS (E), FRACS, FICS Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Hyderabad, India Department of Neurosurgery, Apollo Hospital, Room No. 39, Jubilee Hills, Hyderabad 500096, India e-mail: [email protected]
The ideal and generally accepted treatment of hydatid disease involving the central nervous system (CNS) is surgical and that medical treatment should be restricted to nonoperable patients. The outcome of treatment depends on many factors such as the species of echinococcal infestation, whether it is primary or secondary, single or multiple; the anatomical location and dimension of the lesion; the result of surgical intervention; the presence and extent of the disease in other parts of the body; and the type and the duration of drug therapy in cases with rupture of a cyst or of cysts during surgery (Saidi 1976; Altinors et al. 2000; Khaldi et al. 2000; Turgut 2002; McManus et al. 2003; Sayek et al. 2001; Izci et al. 2008; Duishanbai et al. 2010). Prognosis is also different for osseous echinococcal lesions of the cranial bones (or the vertebral column), which secondarily involve the neural elements (Reddy et al. 1972, 1979). The cranial hydatidosis and the vertebral hydatidosis are types of bony hydatid disease which produces few pericystic formations and such lesions confined inside bony tissue enlarge by the formation of a large number of daughter cysts with attendant risk of spillage during their removal and inevitable recurrence of the disease at a later stage. Bony hydatidosis causes few tissue reactions by the host, and the value of drug treatment in such cases is questionable. The outcome also varies with the anatomical location of the lesion, depending upon whether it is epidural,
M. Turgut (ed.), Hydatidosis of the Central Nervous System: Diagnosis and Treatment, DOI 10.1007/978-3-642-54359-3_19, © Springer-Verlag Berlin Heidelberg 2014
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D.R. Reddy
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subdural, or subarachnoi
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