Primary Thalamic Hydatid Cyst: A Rare Diagnostic and Surgical Challenge- First African Case Report with Comprehensive Illustration and Literature Review

Abstract

Central nervous system (CNS) hydatidosis is a rare manifestation of hydatid disease, accounting for 2–3% of cases caused by the larval stage of the Echinococcus tapeworm. Hydatid cysts typically localize in watershed regions of the middle cerebral artery, with the parietal lobe being the most common site. Thalamic involvement, however, is exceedingly rare. We present the first documented case of a thalamic hydatid cyst in Africa in a 17-year-old male with an 8-month history of progressive left sided weakness, right-sided facial deviation, involuntary movements, and gait disturbance. Neurological examination revealed spastic left-sided hemiparesis and supranuclear facial palsy. Brain MRI showed a well defined cystic lesion in the right thalamus. The patient underwent craniotomy with intact cyst excision, and histopathological analysis confirmed the diagnosis. Postoperatively, the patient exhibited significant neurological improvement, regaining motor function and a normal gait. This case underscores the importance of considering hydatid cysts in the differential diagnosis of cystic brain lesions in endemic regions and highlights the critical role of early diagnosis and intact surgical removal for favorable outcomes.