Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options

A 23-year-old woman was presented to the Emergency Unit with intracranial hypertension syndrome and blindness in her left eye which had started recently. A cranial native computed tomography scan and a magnetic resonance imaging (MRI) with contrast examinations revealed a giant intracranial cystic l...

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Main Authors: Cosmin-Nicodim Cindea, Vicentiu Saceleanu, Adriana Saceleanu
Format: Article
Language:English
Published: MDPI AG 2021-12-01
Series:Brain Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3425/11/12/1604
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author Cosmin-Nicodim Cindea
Vicentiu Saceleanu
Adriana Saceleanu
author_facet Cosmin-Nicodim Cindea
Vicentiu Saceleanu
Adriana Saceleanu
author_sort Cosmin-Nicodim Cindea
collection DOAJ
description A 23-year-old woman was presented to the Emergency Unit with intracranial hypertension syndrome and blindness in her left eye which had started recently. A cranial native computed tomography scan and a magnetic resonance imaging (MRI) with contrast examinations revealed a giant intracranial cystic lesion, extending into the left frontal lobe, which was compressing the optic chiasm and eroding the internal plate of the left frontal bone. Surgical craniotomy was performed for evacuation and decompression, but during the craniotomy the cyst ruptured. After assessing the degree of erosion of the internal bone plate, we concluded that the primary origin of the cyst was intraosseous. With the dura mater being intact, abundant lavage with H<sub>2</sub>O<sub>2</sub> was applied and the bone flap was replaced after rigorous bone scraping. Imaging control at six and twelve months identified no recurrence of the cyst. In the literature, hydatid cysts located in the skull bone are very rare and most of them rupture intraoperatively. Given their extremely low incidence in developed countries, any neurosurgeons’ experience with such pathology is limited and in some cases surgery cannot be delayed. In the case of intracerebral hydatid cysts, a neurosurgeon usually has only one shot at surgery, so simple and quick-to-access therapeutic guidelines must be developed in order to inform the choice of surgical technique. We conclude that the most successful surgical approach could be double concentric craniotomy. This surgical technique is used in intracerebral tumors, which also have an important bone invasion.
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spelling doaj.art-c6de48d992b349f696a4fbeebabe363a2023-11-23T04:01:57ZengMDPI AGBrain Sciences2076-34252021-12-011112160410.3390/brainsci11121604Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment OptionsCosmin-Nicodim Cindea0Vicentiu Saceleanu1Adriana Saceleanu2Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaFaculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaFaculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, RomaniaA 23-year-old woman was presented to the Emergency Unit with intracranial hypertension syndrome and blindness in her left eye which had started recently. A cranial native computed tomography scan and a magnetic resonance imaging (MRI) with contrast examinations revealed a giant intracranial cystic lesion, extending into the left frontal lobe, which was compressing the optic chiasm and eroding the internal plate of the left frontal bone. Surgical craniotomy was performed for evacuation and decompression, but during the craniotomy the cyst ruptured. After assessing the degree of erosion of the internal bone plate, we concluded that the primary origin of the cyst was intraosseous. With the dura mater being intact, abundant lavage with H<sub>2</sub>O<sub>2</sub> was applied and the bone flap was replaced after rigorous bone scraping. Imaging control at six and twelve months identified no recurrence of the cyst. In the literature, hydatid cysts located in the skull bone are very rare and most of them rupture intraoperatively. Given their extremely low incidence in developed countries, any neurosurgeons’ experience with such pathology is limited and in some cases surgery cannot be delayed. In the case of intracerebral hydatid cysts, a neurosurgeon usually has only one shot at surgery, so simple and quick-to-access therapeutic guidelines must be developed in order to inform the choice of surgical technique. We conclude that the most successful surgical approach could be double concentric craniotomy. This surgical technique is used in intracerebral tumors, which also have an important bone invasion.https://www.mdpi.com/2076-3425/11/12/1604hydatid cystintracranial extraduralrupturecase reportcraniotomy
spellingShingle Cosmin-Nicodim Cindea
Vicentiu Saceleanu
Adriana Saceleanu
Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options
Brain Sciences
hydatid cyst
intracranial extradural
rupture
case report
craniotomy
title Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options
title_full Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options
title_fullStr Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options
title_full_unstemmed Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options
title_short Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options
title_sort intraoperative rupture of an intracranial extradural hydatid cyst case report and treatment options
topic hydatid cyst
intracranial extradural
rupture
case report
craniotomy
url https://www.mdpi.com/2076-3425/11/12/1604
work_keys_str_mv AT cosminnicodimcindea intraoperativeruptureofanintracranialextraduralhydatidcystcasereportandtreatmentoptions
AT vicentiusaceleanu intraoperativeruptureofanintracranialextraduralhydatidcystcasereportandtreatmentoptions
AT adrianasaceleanu intraoperativeruptureofanintracranialextraduralhydatidcystcasereportandtreatmentoptions