Outcome of Therapies for Echinococcal Infections of the Central Nervous System in Children

• Poor outcome, especially with spine disease: Hydatid disease is generally a severe disease, with a mortality rate greater than 90% in untreated patients. Despite all the advances in imaging techniques and therapeutic methods, CNS hydatidosis remains difficult to cure, and the outcomes are unsatisfactory, especially in cases of spinal involvement due to the high incidence of recurrence (32).

Outcome After Surgery

• Recurrence risk function of size of primary cyst: Gigantic cysts are easily ruptured during surgery, and recurrence is likely (49). 

• 40% recurrence with secondary disease in spine: Vertebral involvement is common in the spinal form of the disease, and such cysts have the disadvantages of being microvesicular, invasive, and often multiple in nature (1, 5, 7).  Such features create problems for total removal as well as increase the incidence of rupture and, consequently, that of recurrence. A recurrence rate of 40% has been reported for cases in which treatment is delayed, and the incidence of paraplegia due to recurrent disease is reported to be 25–45% (1).