Abstract

Objective
To optimize diagnostic approaches and surgical management for patients with multiple cerebral hydatid cysts.
Materials and Methods
A retrospective analysis included 13 patients (6 women [46.2%] and 7 men [53.8%]) with multiple cerebral hydatid cysts, treated at the Neurosurgery Department from 1988 to 2022. The mean age was 30.8 ± 11.9 years (range: 18–60 years).
Results
Upon admission, patients presented different clinical phases: subcompensation (n=4, 30.8%), moderate decompensation (n=7, 53.8%), and severe decompensation (n=2, 15.4%). Due to slow cyst growth and gradual development of compensatory mechanisms, the disease often has a prolonged asymptomatic course, with clinical presentation typically involving general cerebral, focal, and brain displacement syndromes. Echоencephalography (ECHO-EG) revealed a mean midline shift of 9.9 mm. Computed tomography (CT) and magnetic resonance imaging (MRI) were the primary diagnostic modalities. Cyst diameter ranged from 1.1 to 6.0 cm. The hydrodynamic expulsion technique was used as a radical surgical method, offering the advantages of protecting surrounding brain tissue from the toxic effects of cyst fluid, preventing anaphylactic shock and parasite dissemination, reducing postoperative complications, and minimizing the risk of recurrence
Conclusion
Multiple cerebral hydatidosis is a severe parasitic infection. The introduction of modern neuroimaging diagnostics and refined surgical strategies into neurosurgical practice has significantly improved treatment outcomes for this condition.

Keywords

diagnosis surgical treatment hydatid cyst cerebral echinococcosis neurosurgery hydrodynamic expulsion

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