Neurological disorders caused by two cerebral alveolar hydatid cysts in an old woman: a rare case report

Alveolar hydatid disease, caused by Echinococcus multilocularis, is a life-threatening infectious disease which primarily occurs in the liver. Intracranial hydatid disease is a rare presentation with reported incidence of ~1% of all cases. Here we reported a 60-year-old woman, with the past history of hydatid cysts in her liver, who was presented to us with progressive symptoms consist of headaches, diminished vision, cognitive disorders and delusion. She was disoriented in time, space and person. Bilateral mild papilledema and exaggerated reflexes were observed. Magnetic resonance imaging of the brain revealed two intra-axial multilucular cystic masses in the fronto-pareital and parieto-occipital regions. The patient underwent two operations and the lesions were removed without any rupture. Medical therapy with Albendazole was started. Neurological symptoms disappeared a few weeks after the surgeries. Although multiple alveolar hydatid cysts are extremely rare, they should be considered in the differential diagnosis of intracranial cystic lesions.