Surgical treatment in nervous system echinococcosis in Qinghai-Tibet Plateau

Abstract Purpose: To summarize the experience of diagnosis and treatment of echinococcosis in nervous system in Qinghai-Tibet Plateau.Methods: Patients with echinococcosis of nervous system treated in Qinghai Provincial People's Hospital from January 2010 to September 2018 were selected. All patients were examined by enzyme linked immunosorbent assay and imaging examination. During the hospital, all patients received surgery. After operation, patients exanimated regularly and followed up for one year.Results: A total of 13 patients were included in this study. The average age was 38.8±13.7 and seven cases (54%) were male. Among these patients, six cases had cystic echinococcosis and seven cases with alveolar echinococcosis, meanwhile, eight patients had cerebral echinococcosis and five patients with spinal echinococcosis. The enzyme linked immunosorbent assay indicated positive results in 8 cases and one patient was misdiagnosed as vertebral metastases by imaging examination before operation. One patient recurred after operation but refused treatment. After follow-up for one year, the mRS (Modified Rankin Scale) of cerebral echinococcosis improved from 3.3±0.5 to 2.1±0.4, four cases of spinal echinococcosis improved in ASIA (American Spinal Injury Association).Conclusion: Current evidence indicated that early surgical treatment and oral albendazole might improve the outcome of patients with nervous system echinococcosis in short time.