Susceptibility Artifacts in Ruptured Intracranial Dermoid Cysts: A Poorly Understood but Important Phenomenon

Abstract

SUMMARY -Rupture of intracranial dermoid cyst is a rare event. The classical imaging feature is described as a fat-containing lesion with tiny fat droplets in the subarachnoid or ventricular system. The lesion and the fat droplets show susceptibility blooming artifact on susceptibility-weighted images (SWI). Knowledge of this fact is important because these lesions mimic the blooming artifact of haemorrhage on SWI. The cause of the susceptibility artifact in intracranial dermoids has not been reported in the literature to date. We describe two cases of ruptured intracranial dermoids in the basifrontal region and review the clinical and imaging features and possible causes of susceptibility artifacts in intracranial dermoid cysts.

Dermoid Cyst of the Prepontine Cistern and Meckel's Cave: Illustrative Case and Systematic Review

“…79 Diffusion sequences were only present in 10 of the articles we reviewed. 11,18,19,22,35,37,52,53,59,66 In those cases, DWI displayed minimal to moderate restriction. A diffusion scan for our patient, at recurrence, demonstrated minimal restriction (►Fig.…”

Intracranial Intra-arachnoid Diverticula and Cyst-like Abnormalities of the Brain

“…2,58 Dermoid cyst rupture is diagnosed by the presence of "droplets" with the imaging characteristics of fat within the subarachnoid space, ventricles, or sulci, 2,52,54,58 resulting in aseptic meningitis, as with epidermoid cysts 52,58 ; a susceptibility artifact similar to that of hemorrhage can appear on susceptibility-weighted imaging in patients with ruptured cysts. 52,54,58,59 Treatment Treatment of intracranial dermoid cysts is as for epidermoids, with likelihood of recurrence if the mass cannot be completely resected. 55 Ventriculoperitoneal shunting is performed in human and canine patients with an associated hydrocephalus.…”

Ruptured intracranial dermoid cysts: a pictorial review

“…The most common symptoms are headache (32.6%), followed by seizures (26.5%), cerebral ischaemia (16.3%), and aseptic meningitis (8.2%) [6]. Specifically, patients with dermoid cysts located in posterior fossa can present with hydrocephalus caused by occlusion of the ventricular system [7]. However, in some cases cysts are also found incidentally.…”