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Cerebral hydatid cyst — DTM&H MCQ

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HardHelminthic InfectionsCerebral hydatid cystDTM&H

A shepherd from Morocco has a 7-cm, spherical, non-enhancing intracranial cyst with minimal surrounding oedema. Echinococcus serology is positive. Which proposed diagnostic or therapeutic step creates the greatest avoidable immediate hazard?

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Correct answer: A — Stereotactic puncture for pre-operative cyst-fluid confirmation

The best answer is “Stereotactic puncture for pre-operative cyst-fluid confirmation”. Puncturing a viable cerebral hydatid cyst can spill protoscolices, seed daughter cysts and provoke anaphylaxis. Imaging and epidemiology usually establish the working diagnosis; management centres on specialist intact removal with adjunctive antihelminthic therapy rather than pre-operative aspiration.

Reference: Cerebral hydatid disease: neurosurgical review: https://pmc.ncbi.nlm.nih.gov/articles/PMC3205482/