Pediatric cerebral hydatid cyst with irreversible visual sequelae after surgical resection: case report

Abstract

Cystic echinococcosis is a neglected zoonosis endemic to rural and livestock-raising regions of Latin America. Despite the infrequency of brain involvement, it is clinically significant due to its association with intracranial hypertension, neuro-ophthalmologic deterioration, and permanent sequelae.
This is a case report of a 12-year-old boy from a rural high-Andean area of Huancayo, Peru, with a history of close contact with dogs and exposure to livestock. The child presented with a progressive headache and reduced visual acuity. The images revealed a left parieto‑occipital intra‑axial cystic lesion with mass effect and midline shift, consistent with a cerebral hydatid cyst. A craniotomy was performed with complete resection. The diagnosis was confirmed by Western blot and histopathology, which revealed few hydatid cysts. He was given albendazole for six months. Neurological recovery was favorable, with no motor deficits; although bilateral optic atrophy remained as a sequela.

In endemic areas, a progressive headache associated with visual deterioration must prompt early neuroimaging and priority referral to a neurosurgeon. A comprehensive approach must include diagnostic imaging, serology, and histology, as well as actions based on the “One Health” approach.