Primary Multiple Cerebral Hydatid Cysts: A Case Report of Unusual Presentation

Background: Hydatid disease is a common infection caused by Echinococcus granulosus. Cerebral involvement is very rare and only occurs in 2% of all hydatidosis in endemic areas. This study reports a case of primary multiple cerebral hydatid cysts in a 23-year- old patient. Case: A 23-year-old female was admitted to the emergency ward with primary generalized tonic colonic seizure, left body and face hemipares, and history of headache in last two months. Contrast enhanced CT and MRI showed a big well-defined, rounded, cystic lesion in the motor strip of right temporo-parietal region with mass effect causing midline shift which was diagnostic for brain hydatid cyst and several smaller cysts. There was no evidence of other organs involvement. The patient underwent brain surgery and a big hydatid cyst (10cm in diameter) and some others adhering to brain parenchyma in different sizes were evacuated completely without rupture using Dowling method. The patient received albendazole 400mg/two times a day for 2 months. There was no cyst in patient’s MRI study in the two-year follow up. Conclusion: Though of low incidence, primary multiple cerebral hydatid cysts should be considered in endemic area using brain CT and MRI. Surgery is considered the standard treatment of the disease.