Intradural Extramedullary Hydatidosis: A Review

Spinal hydatid cysts, mainly in the form of osseous and epidural involvement, account for 1% of all cases of hydatid disease. Primary spinal intradural extramedullary (IDEM) hydatid cysts are extremely rare, with only 49 cases reported in the literature to date. IDEM hydatid cysts, a diagnostic challenge, should be suspected in cases of spinal cord compression, especially in previously treated systemic hydatidosis, or in endemic areas, or if the patient has migrated from or visited an endemic area. It should also be included in the differential diagnosis of IDEM cystic lesions seen on magnetic resonance imagining. Imaging modalities like magnetic resonance imagining have greatly improved the ability to diagnose the hydatid cyst of the spine. Surgical cyst extirpation followed by antihelminthic treatment with albendazole is the treatment of choice. From the review of literature, it seems that, in terms of intradural location and recurrence, intradural hydatid disease behaves differently from osseous and extradural disease.