Intraoperative Rupture of an Intracranial, Extradural Hydatid Cyst: Case Report and Treatment Options

Anticoagulation Reversal in Intracerebral Hemorrhage: A Case Report on the Efficacy of Andexanet Alfa in an Apixaban-Treated Patient

Intracerebral hemorrhage (ICH) presents complex clinical challenges, particularly in patients receiving anticoagulation therapy. This case report discusses the management of acute ICH in a 60-year-old male patient on long-term apixaban therapy, who arrived at the emergency department with altered consciousness, right-sided hemiplegia, and mixed aphasia. Computed tomography (CT) imaging revealed a 70 ml left lenticular-capsular hematoma with significant mass effect, necessitating rapid intervention. Due to the patient's deteriorating neurological condition, andexanet alfa was administered as a reversal agent for apixaban, effectively reducing anti-factor Xa (FXa) activity and enabling an urgent left temporal craniotomy for hematoma evacuation. Postoperatively, the patient received ICU monitoring, blood pressure management, and supportive care, showing gradual improvement in consciousness and sensory aphasia over several days. Despite initial right hemiplegia and motor aphasia requiring rehabilitation, the patient showed excellent progress at one month, now walking independently and managing daily self-care. This report highlights the potential of andexanet alfa for effective anticoagulation reversal in critical ICH cases while also addressing associated thrombotic risks. It underscores the need for a multidisciplinary approach and emphasizes the importance of further research to refine treatment strategies for anticoagulated patients with ICH.

A rare entity of primary hydatid cyst located between the two layers of the intracranial dura in a child: a case report

INTRODUCTION

Hydatid disease is a parasitic infection caused by the tapeworm Echinococcus granulosus. Intracranial locations are rare and account for less than 3% of all cases. Typically, these cysts are found in the intracerebral spaces. However, this study presents an extremely rare intradural hydatid cyst. To our knowledge no similar case has been previously reported.

CASE PRESENTATION

This study presents the case of an 8-year-old boy presented with a 3-month history of headache and vomiting without any neurological deficit. Full radiological investigations were performed, the brain MRI showed a large cerebral hydatid cyst located within the dura layers between the periosteal and the endosteal layers. Surgery was performed without cyst rupture, confirming the intracerebral intradural location.

CONCLUSION

Early diagnosis and treatment for intracranial hydatid cysts are crucial to prevent complications such as neurological deficits, seizures, and even death. In this case, the intracerebral intradural location of the cyst is extremely rare.

Transverse sinus obstruction caused by extradural supra-infratentorial hydatid cyst: A case report and literature review

Approximately 1-3% of cases of hydatid disease involve the central nervous system (CNS). This study aims to report an extremely rare case of supra-infratentorially located epidural hydatid cyst with transverse venous sinus obstruction which presented with chronic cerebral vein thrombosis (CVT) signs and symptoms.