Cerebral cysticercosis and echinococcosis: a preoperative diagnostic dilemma.
BACKGROUND
Seven cases of neurocysticercosis and three cases of neuroechinococcosis with symptoms of elevated intracranial pressure requiring urgent neurosurgical treatment are described. No neuroradiologic procedure established exact diagnosis preoperatively; this was achieved by pathohistologic analysis of bioptic material.


METHODS
Ten patients with duration of clinical symptoms ranging from 1 week to 1 month were operated on at the Department of Neurosurgery of Sestre Milosrdnice University Hospital in Zagreb, Croatia during the period 1988-2000. On receipt, bioptical material was examined pathohistologically at the Ljudevit Jurak Clinical Department of Pathology of the same hospital. We compared our data with facts collected by reviewing the pertinent literature over the past 10 years.


RESULTS
The most common localization of parasitic cysts in our study was posterior cranial fossa, i.e., subtentorial, which, according to the literature, is a rare localization. Due to this unusual localization, dominant clinical symptoms included elevated intracranial pressure, requiring urgent surgical removal of parasitic cysts.


CONCLUSIONS
With the exception of the epidemiologic aspect, cerebral cysticercosis and echinococcosis are important as a true diagnostic and therapeutic problem. These human parasitic zoonoses are rarely diagnosed preoperatively despite newly developed neuroradiologic and serologic methods, especially in cases of primary appearance in brain when exact diagnosis reveals adequate surgical removal with subsequent complete recovery.
Talan-Hranilovic
Jasna
J
Ljudevit Jurak University Clinical Department of Pathology, Sisters of Mercy University Hospital, Zagreb, Croatia. jasna.talan-hranilovic@zg.hinet.hr
Sajko
Tomislav
T
Negovetic
Lucijan
L
Lupret
Velimir
V
Kalousek
Miljenko
M
D000328:Adult; D000368:Aged; D001927:Brain Diseases / Q000175:diagnosis* / Q000601:surgery; D002648:Child; D003388:Cranial Fossa, Posterior / Q000473:pathology; D004443:Echinococcosis / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology; D008875:Middle Aged; D020019:Neurocysticercosis / Q000175:diagnosis* / Q000601:surgery; D012737:Sex Factors