title: A life-threatening brainstem compression by cerebral Echinococcus granulosus.
abstract: Cystic echinococcosis (CE) is a zoonotic disease caused by Echinococcus granulosus. It is of worldwide importance, and is widespread in the Mediterranean region and Middle East. This tapeworm shows great intraspecific variation in relation to host specificity, epidemiology and morphology. This variability led in previous years to the identification of ten (G1-G10) different genotypes of the parasite. Cerebral localization of E. granulosus is not common: it especially affects children and is more frequently located in the supratentorial region. It can be life-threatening due to its localization in eloquent areas especially in the posterior fossa. Despite the benign nature of hydatid cyst, invasion of critical areas may cause significant mortality and morbidity in some patients. Urgent surgical decompression and adjuvant medical treatment must be employed as soon as possible in these patients. We present a clinical case of life-threatening brainstem compression in a child due to a rare form of CE which was confirmed with biomolecular techniques. She presented with respiratory distress and progressive quadriparesis. All cysts were removed by microsurgical technique and albendazole was given postoperatively for one year with regular follow-ups.
authors.affiliation: Infectious Diseases and Clinical Microbiology, Bahçesehir University Medical Faculty, Liv Hospital-Ulus, Istanbul, Turkey.
authors.forename: Zehra Cagla
authors.initials: ZC
authors.lastname: Karakoç
authors.affiliation: Neurosurgery, Liv Hospital-Ulus, Istanbul, Turkey.
authors.forename: Mustafa Omür
authors.initials: MO
authors.lastname: Kasimcan
authors.affiliation: Department of Veterinary Medicine, University of Sassari, Italy.
authors.forename: Anna Paola
authors.initials: AP
authors.lastname: Pipia
authors.affiliation: Department of Veterinary Medicine, University of Sassari, Italy.
authors.forename: Gessica
authors.initials: G
authors.lastname: Tore
authors.affiliation: Department of Veterinary Medicine, University of Sassari, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alberti
authors.affiliation: Department of Veterinary Medicine, University of Sassari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Varcasia
authors.affiliation: Department of Pathology, Nisantasi Pathology Group, Istanbul, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Sav
authors.affiliation: Neurosurgery, Liv Hospital-Ulus, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Oruçkaptan
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000923:Anticestodal Agents / Q000627:therapeutic use*; D001933:Brain Stem / Q000469:parasitology*; D004443:Echinococcosis / Q000175:diagnosis / Q000469:parasitology* / Q000628:therapy*; D048209:Echinococcus granulosus / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods; D011782:Quadriplegia / Q000469:parasitology; D012131:Respiratory Insufficiency / Q000469:parasitology; D016896:Treatment Outcome
chemical_list: D000923:Anticestodal Agents; D015766:Albendazole