Case Report
Multiple fourth ventricular hydatidosis

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Abstract

Hydatid disease caused by ingestion of eggs of the cestode Echinococcus granulosus is endemic in the Middle East, Mediterranean countries, South America, North Africa and Australia.1 Infratentorial occurrence of hydatid cyst is rare. We present a report of an extremely rare case of multiple exclusive fourth ventricular hydatid cysts, both primary and secondary, and discuss problems with the diagnosis and management of this condition.

Introduction

Intracranial hydatid disease is seen in 1% to 2% of all patients with hydatidosis and it accounts for 0.02% to 0.22% of all intracranial space-occupying lesions.2 Although infrequent, posterior fossa hydatid disease should be considered in the differential diagnosis of cystic infratentorial lesions in endemic areas.

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Case report

An 8-year-old girl from rural India presented with occipital headache, vomiting and deterioration of vision over a period of 1 year. On examination, she had poor visual acuity and her fundus showed secondary optic atrophy. She had limb spasticity, coarse lateral gaze nystagmus and cerebellar signs in the form of dysmetria, dysdiadokokinasia and a broad based ataxic gait.

MRI showed two cystic lesions with fluid of cerebrospinal fluid (CSF) intensity in the fourth ventricle and nodular

Discussion

Intracranial hydatidosis is more common in the paediatric than in the adult population.3 Multiple intracranial hydatid cysts are rare and are seen in about 10% to 15% of cases of intracranial hydatidosis.4 A literature search (PubMed) revealed four reports of solitary hydatid cyst in the fourth ventricle.[2], [3], [4], [5], [6], [7] To our knowledge, this is the first report of an exclusive case of multiple secondary hydatid cysts in the fourth ventricle.

Intracranial hydatid cyst may be

References (12)

  • C. Onal et al.

    Three unusual cases of intracranial hydatid cysts in the pediatric age group

    Pediatr Neurosurg

    (1997)
  • A. Rahimizadeh et al.

    Hydatid cyst of the fourth ventricle

    Neurosurgery

    (1984)
  • S. Gupta et al.

    Intracranial hydatid cyst: A report of five cases and review of literature

    Neurol India

    (1999)
  • H.C. Ugur et al.

    Secondary multiple intracranial hydatid cysts caused by intracerebral embolism of cardiac echinococcosis

    Acta Neurochir (Wien)

    (1998)
  • M. Gelabert Gonzalez et al.

    Hydatid cyst of the fourth ventricle

    Rev Quir Esp

    (1988)
  • M. Choux et al.

    Hydatid cyst of the fourth ventricle in a six-year-old child

    Mod Probl Paediatr

    (1976)
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