Delayed presentation of giant cerebral hydatid cyst with epilepsy: A case report

• Emphasis on the need for early diagnosis to avoid delayed presentation and severe neurological symptoms in low-income settings. • Effective use of Dowling’s technique for successful surgical removal of giant cerebral hydatid cysts. • Importance of preoperative and postoperative albendazole therapy in preventing recurrence. Cerebral hydatid disease, although rare, presents a significant health risk, particularly in low-income countries where delayed diagnosis and treatment are common. This parasitic infection is more prevalent among children and young adults, with symptoms often manifesting only when the cysts grow large due to the disease’s indolent nature. Case Description: We report the case of an 18-year-old male presenting with an 8-year history of abnormal body movements (epilepsy) and left-sided weakness. Neurological examination revealed a muscle power of 2/5 in the left upper extremity and 3/5 in the left lower extremity (MRC scale). Imaging identified a large right fronto-parietal cerebral hydatid cyst, confirmed by histopathological analysis. The patient received preoperative oral albendazole (400 mg daily) for 14 days. The cyst was successfully removed intact using Dowling’s technique without rupture. This case highlights the urgent need for increased awareness and timely intervention for cerebral hydatid disease in low-income countries. Delayed presentations with severe neurological symptoms show there are barriers to early diagnosis and treatment. Effective use of Dowling’s technique and preoperative albendazole shows that successful outcomes are possible, even in resource-limited settings. Enhancing healthcare access and education on parasitic infections can improve early diagnosis and patient outcomes.