Ruptured intracranial dermoid

Case contributed by Dr Y. Amy Chen

Presentation

60 year-old male presented with sudden onset of headache.

Patient Data

Age: 60
Gender: Male
CT

Axial non-contrast CT demonstrates multiple hypodensities with fat attenuation at the left gyrus rectus and interhemispheric fissure anteriorly.

MRI

Multiple sequences through the brain demonstrate disseminated fatty droplets within the subarachnoid space, compatible with a ruptured dermoid.

Case Discussion

General features:

Dermoid cysts are benign masses with mature squamous epithelium as well as adnexal structures such as hair follicles and sebaceous glands.  The oils from hair follicles is in part thought to relate to the lipid content.

Epidemiology:

These are much less common than epidermoid cysts and typically present in relatively much younger patients (age between 20-30s). These cysts are often asymptomatic unless they rupture, which may be further complicated by chemical meningitis that may result in seizure or infarction.

Imaging:

Because these are fatty lesions, both CT and MRI should demonstrate lesions that follow fatty density or intensity, respectively. 

 

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Case information

rID: 51391
Case created: 14th Feb 2017
Last edited: 10th Dec 2017
Inclusion in quiz mode: Included

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