Preparation for Surgery for Echinococcal Infections of the Central Nervous System in Children

Indications for Procedure

• Findings suggestive of hydatid cyst disease: Findings such as an enlarged cyst, clinical and neurological signs, and cyst-mass effects may be indication for a procedure.

Preoperative Orders

• Routine

Anesthetic Considerations

• Routine

Devices to Be Implanted

• None

Ancillary/Specialized Equipment

• Microscope: A microscope must be used, especially during the dissection of the cyst from the normal surrounding parenchyma. The surgeon must visualize the circumference of the cyst to determine if any adhesions are present between the cyst and normal tissue.
• Endoscope: Neuroendoscopic assistance may be required, especially for cysts that are deeply seated in the CNS or are in the ventricle.
• Neuronavigation
• Intraoperative imaging (ultrasound, CT, MRI): Intraoperative imaging is useful for small or deeply placed cysts. Ultrasound may be preferable for cysts that are small and close to the surface. CT and MRI may be required for cysts with deep localization.
• IOM: IOM is particularly helpful when working with hydatid cysts in the spinal canal.