Ruptured intracranial dermoid cyst
Acute onset of severe headache.
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The patient had a history of hydrocephalus and underwent a VP shunt insertion.
Complex right temporal intra-axial lesion. In T1 it displays heterogeneous intensity predominantly low signal in the center of the lesion with peripheral hyperintensity. In T2 the lesion is predominantly hyperintense in the center and periphery. The peripheral component becomes low signal in fat suppressed T2. Scattered foci of hyperintense signal in T1 and FLAIR are seen disseminated within the subarachnoid space.
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Diagnosis: dermoid cyst after rupture.
The dermoid cyst has ruptured and its fatty content becomes disseminated within the subarachnoid space resulting in T1/FLAIR hyperintense droplets. After evacuating its content, its center became hypointense on T1 and may resemble any other cystic lesions.
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