Ruptured intracranial dermoid

Case contributed by A.Prof Frank Gaillard

Presentation

Acute headache.

CT

A fat-density mass is seen in the interhemispheric fissure anteriorly, with multiple small droplets of similar material scattered superiorly within the subarachnoid space. These features are almost pathognomonic of a ruptured intracranial dermoid cyst, with this only alternative possibility being a mature cystic teratoma, although the absence of a solid or calcified component makes this most unlikely. 

MRI

Fatty composition is confirmed on fat saturated FLAIR sequencing demonstrating complete suppression. 

Case Discussion

Ruptured dermoids can mimic a clinical subarachnoid when they rupture due to the sudden onset of a headache. Identifying fatty density is the key to the diagnosis. 

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Case information

rID: 10582
Published: 23rd Aug 2010
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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