Supratentorial hydatid cyst with cerebellar signs: a rare case of diaschisis

Abstract.

Background: Intracranial hydatid disease has a distinct predominance in the pediatric age group and still causes serious problems in endemic areas. Case report: A 7-year-old girl admitted with a 3-month history of illness involving the main symptoms of ataxic gait, apraxia, headache, and tremor and with positive cerebellar signs and papilledema is presented. Results: Cranial computerized tomography and magnetic resonance imaging revealed a right temporoparietal spherical lesion measuring 50×60×80 mm, which had a significant mass effect. A preoperative diagnosis of intracranial hydatid cyst was confirmed during the surgical procedure, which allowed removal of the cyst intact. The postoperative course was uneventful. Conclusions: The aim of this presentation is to emphasize the necessity for considering diaschisis – inhibition of function produced by a focal disturbance in a portion of the brain at some distance from the original site of injury, but anatomically connected with it through fiber tracts. We believe that this case, with a mass lesion in a temporoparietal location and definite clinical manifestations with plentiful cerebellar signs, is a good example of this rare phenomenon.