Status epilepticus due to a ruptured dermoid cyst.

Abstract

A 51 year old man with a negative neurological history presented to the accident and emergency department with a generalised tonic clonic seizure. Further fits occurred with the patient not regaining consciousness. Brain CT showed a partially calcified right frontal tumour containing fat. Free intraventricular and subarachnoidal fat suggested rupture of a dermoid cyst.

Oiled Brain and Status Epilepticus: Intraventricular and Subarachnoid Rupture of a Temporal Dermoid Cyst

“…The clinical history is related to their mass effect on the neural structures, and their slow rate of progression explains the considerable size they might reach. Rarely, as shown in our case, dermoids can rupture within the ventricular system, the subarachnoid or the subdural spaces [1,2,[5][6][7][8][9][10][11]. Formerly, these incidents were considered to be dramatic [7].…”

“…The presence of these droplets has been incriminated in the genesis of vasospasm, which has been well documented in animals but not yet in humans [12]. Status epilepticus has exceptionally been reported [11]. Most ruptured dermoids described in the literature, involved the supratentorial floor (sellar region 34.1%, frontal lobe 29.6%, temporal 13.6%) while the posterior fossa was concerned in only 4.5% [1].…”

Interdural giant dermoid cyst of the petrous apex

“…Furthermore, in this region, the dura mater of the MCF floor duplicates itself as a double layer to constitute Meckel's cave and the lateral wall of the CS. 13,14 Infrequently these tumours rupture spontaneously 1,[15][16][17][18][19] or following trauma, 20,21 spreading their content within the subarachnoid and/or intraventricular space, causing chemical meningitis and ventriculitis, headache and seizures. Intratumoral haemorrhage is, however, rare.…”

Giant Middle Fossa Epidermoid Presenting as Holmes’ Tremor Syndrome

“…Intracranial dermoids may gradually reach an enormous size before the onset of symptoms. 1 , 2 Common clinical presentations of intracranial epidermoid include headache and seizures, 3 , 4 and the latter can be important clinical presenting features in patients in which the tumor is in proximity to the temporal lobe. 5 We present a case of a female patient with a giant middle fossa epidermoid that presented with Holmes’ tremor syndrome; we also review the relevant literature.…”