Summary
The authors report four patients with intracranial hydatic cysts. One patient had a pontine lesion which was punctured and aspirated and the cyst wall removed with a satisfactory outcome. The second patient had multiple cysts which was comparable to meningeomatosis. She had a rapidly deteriorating neurologic condition which proved to be fatal in spite of two consecutive surgical interventions. The third patient had nine lesions although only six were evident on the MRI. All of the cysts were removed, while two cysts ruptured. Multiple paracardial cysts of this patient were surgically removed shortly after the craniotomy. The last patient, again with multiple intracranial hydatid cysts had safe, total removal of all cysts. The first postoperative control CT raised the possibility of recurrence since the CT was highly suggestive of a hydatid cyst. However, this was not confirmed in the follow-up CT examination. Problems and the solutions of management are discussed.
Zusammenfassung
Die Autoren berichten über vier Fälle mit intrakraniellen Echinococcus-Zysten. Eine Patientin hatte eine Brückenläsion, die durch Punktion und Aspiration des Zysteninhaltes mit Entfernung der Zystenwand behandelt wurde. Die zweite Patientin wies multiple Zysten auf, die mit einer Meningomatose vergleichbar waren. Trotz zweier chirurgischer Interventionen kam es zur raschen neurologischen Verschlechterung mit tödlichem Ausgang. Der dritte Patient hatte neun Herde, von denen sich im Kernspintomogramm nur sechs darstellten. Alle Zysten wurden entfernt. Bei zwei Zysten kam es zur Ruptur. Kurz nach der Kraniotomie wurden bei diesem Patienten multiple parakardiale Zysten chirurgisch entfernt. Bei der vierten Patientin bestanden ebenfalls multiple intrakranielle Echinococcus-Zysten, die alle sicher exstirpiert werden konnten. Beim ersten postoperativen Kontroll-CT bestand aufgrund der zystenähnlichen Strukturen Verdacht auf ein Rezidiv, der sich bei der Wiederholungsuntersuchung jedoch nicht bestätigte. Probleme und therapeutisches Management werden diskutiert.
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Altinörs, N., Senveli, E., Dönmez, T. et al. Management of problematic intracranial hydatid cysts. Infection 23, 283–287 (1995). https://doi.org/10.1007/BF01716287
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DOI: https://doi.org/10.1007/BF01716287