Intracranial hydatidosis in Turkey: its clinical presentation, diagnostic studies, surgical management, and outcome. A review of 276 cases.

Hydatid disease is still a major health problem in the infested areas of the world, especially in rural areas. Two hundred seventy-six Turkish cases with intracranial hydatidosis have been published since 1960. Based on the records of these cases, the clinical data, neuroradiological findings, treatment, and outcome of intracranial hydatidosis are reviewed. Demographically seen, there was a substantial prevalence of male patients--167 cases (61%). Most of the patients with intracranial hydatidosis were from rural areas and the cysts were generally located in the cerebral hemispheres. In 100 patients, two or three lobes were affected and the cysts were multiple in 53. This infestation was also reported in rare locations such as the ventricular system, extradural space, posterior fossa, pons, sella turcica, parasellar area, and cavernous sinus. Only 49 patients (18%) had other organ infestation. The majority were operated on immediately after diagnosis was established. Operative mortality was 9% and postoperative complications developed in 26 patients. In my reference studies, only 16 cases of recurrence have been seen. This study confirms that hydatid disease is a difficult health problem in Turkey and demonstrates that surgery plus chemotherapy has considerably improved the prognosis, but local disinfectant application is not useful to devitalize the cystic contents. The dimensions, localization and numbers of the cysts are important determinants of the outcome.