Ruptured intracranial dermoid cyst: a case report

Murrone, Domenico; Romanelli, Bruno; Ierardi, Aldo

doi:10.15761/imm.1000247

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Cranial dermoid cysts are rare, and to the best of our knowledge, there are only 10 previously published cases (Table 1) [4][5][6][7][8][9][10][11][12]. They occur near the midline and arise from epithelial cells abnormally retained during the closure of the neural tube during embryologic development.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Rupture of a Skull Base Dermoid Cyst Mimicking Chronic Meningitis

Taha¹,

Abdelrazek²,

Manalo³

et al. 2022

Cureus

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Cranial dermoid cysts are rare, embryologic tumors containing fat, hair, and other ectodermal elements. They occur most frequently in the posterior fossa and are typically diagnosed as incidental findings on brain imaging done for an unrelated reason. Traumatic rupture of a previously unidentified intracranial dermoid cyst can mimic symptoms of post-concussion syndrome and should be ruled out with magnetic resonance imaging (MRI). Surgical intervention after traumatic rupture may not result in complete symptom control due to the persistence of dermoid cyst debris in the subarachnoid space. Here, we present the clinical scenario and radiological features of a ruptured dermoid cyst due to trauma, highlighting a rare complication of a classically benign lesion.

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Section: Discussionmentioning

confidence: 99%

Traumatic Rupture of a Skull Base Dermoid Cyst Mimicking Chronic Meningitis

Taha¹,

Abdelrazek²,

Manalo³

et al. 2022

Cureus

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“…A handful of cases in the literature have documented hydrocephalus following intracranial dermoid cyst rupture ( Table 1 ). Some of these studies at least partially credited disseminated fat for playing a role in the development of hydrocephalus ( 8 , 9 , 11 , 19 , 20 , 22 ). In a report of a ruptured right parasellar dermoid cyst that led to convulsive seizures a few years after removal, Fukui commented that the symptoms were likely due to residual fat particles in the Sylvian cistern, and concluded that these should be removed as much as possible at the time of surgery ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Ruptured Suprasellar Dermoid Cyst Treated With Lumbar Drain to Prevent Postoperative Hydrocephalus: Case Report and Focused Review of Literature

et al. 2021

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Background: Ruptured intracranial dermoid cysts are extremely rare. Standard treatment consists of endonasal decompression or craniotomy with evacuation and copious irrigation of subarachnoid spaces to remove any disseminated cystic contents. Disseminated fat particles in the subarachnoid space may be the cause of further sequalae, including the subsequent development of chemical meningitis and hydrocephalus. Here, we present a case of ruptured suprasellar dermoid cyst treated with craniotomy for emergent optic nerve decompression, followed by postoperative hydrocephalus successfully treated with lumbar drain.Case description: We describe a 30-year-old man with a history of migraines who presented with acute onset of headache, photophobia, nausea, vomiting, and vision loss in the left eye. Head CT and brain MRI demonstrated a ruptured suprasellar dermoid cyst with associated mass effect on the optic nerves and frontal lobes as well as fat attenuation material within the subarachnoid spaces. The patient underwent left frontotemporal craniotomy for cyst resection and developed non-obstructive hydrocephalus on postoperative day 1, refractory to external ventricular drainage. Placement of a lumbar drain cleared the subarachnoid space of debris derived from the ruptured dermoid cyst, and the hydrocephalus resolved. The patient did not require permanent CSF diversion.Conclusions: Intracranial dermoid cysts are uncommon, and rupture is a rare event. Standard surgical treatment with craniotomy for evacuation may leave disseminated dermoid contents and fat particles throughout the subarachnoid spaces. We highlight a case of ruptured suprasellar dermoid cyst with postoperative communicating hydrocephalus treated with lumbar drain when external ventricular drain (EVD) was ineffective. Review of the current literature reveals inconsistent findings on the effects of remaining fat particles. In cases with clinical evidence of increased intracranial pressure due to non-obstructive hydrocephalus attributable to chemical meningitis, temporary lumbar drainage is an option to be considered before committing the patient to permanent shunting.

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“…It contains sweat glands, sebaceous glands and hair follicles. [1,2] These lesions may present with local mass effect, headache or features of meningitis. [3] Dermoid cysts have tendency to cause significant morbidity by compression of the adjacent neurovascular structures, and rarely, these can also rupture with intracystic content disseminating into the subarachnoid spaces.…”

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confidence: 99%