Author Affiliations: Departments of Pathology (Drs Bartosch and Castro) and Neuroradiology (Dr Reis), Hospital São João, Porto, Portugal
A 6-year-old boy from Romania with an 8-month history of progressive right-sided weakness developed a left parietal headache and refused to eat for 2 days. He appeared to be well developed and nourished, without fever or vomiting. Examination showed right hemiparesis without facial involvement. Results of routine laboratory examinations were within normal limits. Magnetic resonance imaging (Figure 1) showed a large (8 cm), well-demarcated cystic lesion in the left frontal lobe with midline shift and left uncal herniation. The lesion's signal intensity was similar to that of cerebrospinal fluid at all sequences, including diffusion. These findings were highly suggestive of hydatid cyst. The cyst was removed intact, using isotonic solution for pericystic space dissection and hydrostatic expulsion. Histologic examination (Figure 2) confirmed the diagnosis. Postoperatively, the patient had rapid recovery from all signs and symptoms.
Bartosch C, Reis C, Castro L. Large Solitary Cerebral Hydatid Cyst. Arch Neurol. 2011;68(7):946-947. doi:10.1001/archneurol.2011.145