Central nervous system hydatidosis in Turkey: a cooperative study and literature survey analysis of 458 cases

Object. Hydatidosis is both a medical and an economic problem in Turkey. Th e aim of this study was to analyze central nervous system (CNS) involvement in this disease, the related problems the disease causes, and its diagnost ic and therapeutic aspects. Methods. The authors conducted an extensive literature survey of the subjec t, in which papers published by Turkish authors in international and domest ic journals were carefully analyzed. In addition, the authors conducted a c ooperative study in which data were gathered from 47 neurosurgery departmen ts across the country. The purpose was to determine the current status of t he disease in Turkey; thus, each unit was questioned about their experience over the past 5 years. Contrary to common belief, the incidence of hydatidosis has not decreased s ignificantly in Turkey. However, computerized tomography and magnetic reson ance imaging have tremendously increased diagnostic specificity. Incidences of morbidity and mortality have improved over time, according to the resul ts of the cooperative study, although these changes are not statistically s ignificant. This may be attributed to experience that has been gained and t o more frequent use of chemotherapy, as reflected by the cooperative study data. The two statistically significant findings of that study were expande d use of chemotherapy in the management of hydatidosis, and a higher rate o f extraneural involvement in the disease. The cooperative study revealed th at chemotherapy was being used more often and that there was a wider range of indications for this treatment than previously reported. The higher rate of extraneural involvement was predictable because lesions in the CNS are typically secondary in this disease. With regard to the studies' findings o n cases of spinal hydatid cysts, the authors found that administration of c hemotherapeutic drugs was the only statistically significant parameter (t = 3.78, p < 0.05), with the rate of chemotherapy higher in the cooperative s tudy. Conclusions. Morbidity, mortality, and recurrence rates of hydatidosis unco vered by the cooperative study and the literature survey were not statistic ally significant.