Hydatid cyst of the ambient cistern radiologically mimicking an arachnoid cyst

Hydatid cysts of the posterior fossa are extremely rare. Intracranial hydatid cysts are more common in children and occur more frequently in the supratentorial space. A 7-year-old boy was admitted to the emergency department because of intense headache, nausea, vomiting, and progressive drowsiness that developed within the period of a week. On radiological examination a round, 2.5 × 2.5-cm cystic lesion appeared in the ambient cistern and caused hydrocephalus as a result of extrinsic aqueductal stenosis. The cyst was successfully removed using the puncture, aspiration, irrigation, and resection technique via an infratentorial-supracerebellar approach with the patient in the sitting position. The authors here described an unusual case of a hydatid cyst in the left ambient cistern with hydrocephalus due to extrinsic aqueductal stenosis, which seems to be the first such case in the literature. Hydatid cyst may be considered in the differential diagnosis of arachnoid cysts of the quadrigeminal cistern to determine which surgical procedure to perform and to avoid unexpected complications.