Gamma knife radiosurgery and albendazole for cerebral alveolar hydatid disease

Abstract

Standard treatment of cerebral alveolar hydatid disease consists of open brain surgery and systemic albendazole. We describe a patient with inoperable cerebral alveolar hydatid cysts on whom gamma knife radiosurgery was used instead of open brain surgery. Because of the size of the multicystic lesion, the gamma knife procedure was done in two sessions. Repeated courses of albendazole were given concurrently. Magnetic resonance imaging follow-up studies showed marked shrinkage of the irradiated cystic structures and initially increased perifocal edema. At a follow-up visit 3 years after gamma knife radiosurgery, the polycystic lesion, the perifocal edema, and the neurological symptoms had all markedly decreased. The patient is now stable and has minimal neurological symptoms, and the quality of her life has improved. Gamma knife radiosurgery may be an alternative for patients with cerebral alveolar hydatid disease for whom surgery is not possible.