Intracranial Dermoid Research Articles

Headache in Ruptured Intracranial Dermoid Cysts.

Intracranial dermoid cysts are benign, rare mass-occupying lesions of the central nervous system arising from the neuroectodermal cell lines. While rupture of intracranial dermoid cysts is rare, it can present with a variety of clinical manifestations. To explore the headache manifestations among patients with ruptured intracranial dermoid cysts. To our knowledge, limited studies focusing on headache due to the intracranial dermoid cysts rupture have been published to date. A literature review was done through PubMed/Medline. Articles within the past 10years were reviewed. Articles in languages other than English were excluded. Rupture of intracranial dermoid cysts could have various manifestations including headache, seizure, and meningitis. Depending on the location of the cyst, headache secondary to the rupture of the intracranial dermoid cysts could present in different ways. A detailed systematic literature review of headache presentations due to intracranial dermoid cysts rupture is provided.

Microsurgical Resection of Intracranial Dermoid and Epidermoid Tumors

Objective: To Ascertain the outcome of microsurgical resection of intracranial dermoid and epidermoid tumors.Materials and Methods: This prospective study was carried out in Neurosurgical Department, Lady Reading Hospital (LRH) Peshawar and followed for 3 years after microsurgical resection. All the patients with suspected intracranial Dermoid and epidermoid tumors (IDETs) on imaging study pre-operatively and later confirmedpostoperatively (after histopathology) were enrolled. Patients having recurrent tumor, opting for nonsurgical management and those deem unfit for surgery were not included in the study.Results: 27 patients were included in the study with 12 (44.4%) males and 15 (56.6%) female. Age of the patients rangefrom 11 to 58 years.Mean age was 38.6 years. Epidermoid tumors were 19 (70.3%) in number and dermoid 8 (29.7%) in number. The most common presentation was increased intracranial pressure (ICP) and cranialnerve deficit. The lesion was located in infratentorial location in 15 (56.6%) patients, 12(44.4%) were supratentorialy located. Gross total removal (GTR) was performed in 21 (77.8%) patients, while in six patients (22.2%) subtotal removal (STR) was attempted. 1 (3.7%) patient died while 2 (7.4%) patients had permanent morbidity post operatively, all other patients (89%) improved. Recurrence occurred in 9.5% of GTR patients while in STR patients, 33.3% patients were noted with increase in residual tumor on neuroimaging.Conclusion: Microsurgical resection with GTR is possible for most IDET and gives good results with minimalcomplications.

Unilateral akathisia and choreoathetosis as an unusual presentation of a frontal lobe dermoid cyst

Objective To consider an unusual presentation of a frontal lobe dermoid cyst. Intracranial masses very rarely present with movement disorders. We describe a highly unusual presentation of an intracranial dermoid with unilateral choreoathetosis, akathisia and facial tics. Material A 63-year-old man presented with left-sided akathisia and tardive dyskinesia of his upper limb, attributed to a dermoid cyst in the right frontal lobe. Resection of the cyst led to a complete resolution of his symptoms without neurological deficit. Conclusion Pathogenic mechanisms of such symptoms may include compression and ischaemia of the basal ganglia and other nigrostriatal structures, as well as dysfunction of the supplementary motor area and mesolimbic dopaminergic pathways.

An Extremely Rare Case Report of Foramen Magnum Dermoid Cyst Presenting as an Acute Progressive Neurologic Deficit

Intracranial dermoid cysts are nonneoplastic lesions that present a rare clinical entity. They account for 0.04% to 0.6% of all intracranial tumors. Such cystic lesions usually contain different ectodermal derivatives including hairs, sebaceous glands, apocrine gland and teeth. Dermoid cysts of foramen magnum occur very rarely, with few cases reported in the literature. Computed tomography (CT) and magnetic resonance imaging (MRI) are two main diagnostic tools. Here in this paper, we described a case of intracranial (foramen magnum) dermoid cyst presented with neurologic deficits that completely removed surgically.

Ruptured intracranial dermoid cysts: A retrospective institutional review

Intracranial dermoids (ID) are relatively uncommon. They are usually located in the midline or posterior fossa, and present in the first three decades of life. Rupture of IDs are a rare occurrence, and can present with diverse clinical features. They have a characteristic appearance on Computerized Tomography (CT) and Magnetic-Resonance-Imaging (MRI). Here we retrospectively review the clinical features, radiology, treatment and outcomes of ruptured IDs managed in our institute. We did a retrospective review of all the IDs from 2011 to 2017 that presented to us with rupture, or that were diagnosed to have ruptured based on imaging characteristics. Nine patients qualified for our study. The data of all 9 patients was analyzed retrospectively and their demographic details, clinical variations, and radiological features were studied and analyzed. Mode of management and outcome was assessed. Mean age of the patients was 32.1 years (SD 7.65) with male-female ratio of 7:2. Patients presented with either headache or seizures in the majority. Two patients had hydrocephalus requiring shunts. Despite their varied location and clinical features, all lesions showed similar and characteristic radiological features-namely, fat droplets in subarachnoid spaces, hypo-intensity on Susceptibility-Weighted-Imaging (SWI) with chemical shift artifact. Treatment of patients varied from medical management in 4, to cerebrospinal fluid (CSF) diversion in 2 and surgery for the lesion in 3 cases. Ruptured IDs present with a wide array of clinical features. Imaging characteristics are fairly distinct and consistent, which aids in diagnosis. Decision for mode of management has to be decided based on case-by-case basis.

Rare cause of seizures: ruptured intracranial dermoid cyst.

Rare cause of seizures: ruptured intracranial dermoid cyst.

Three Rare Localizations of Intracranial Dermoid Tumors

Three Rare Localizations of Intracranial Dermoid Tumors

Double paramedian occipital dermal sinus revealing an infected intra-dural dermoid cyst of the posterior cerebral fossa: Case report

Abstract Background Intracranial dermoid cysts (DC) are rare benign embryologic tumors. They represent approximately 0.3% of all intracranial tumors. The association of intracranial DC and multiple dermal sinuses is exceptional. Methods A 3 year-old girl presented with headache and vomiting. Physical examination showed nothing abnormal except for a small subcutaneous nodule above the occipital protuberance with a small skin opening. She had no neurological deficits. MRI and CT scan showed a cyst in the posterior fossa with occipital sinuses. The child was treated by total resection of the intra-dural occipital cyst and the abscess though a suboccipital approach and antibiotics after surgery with good outcome. Results Histopathologic examination confirmed a diagnosis of DC, and bacterial investigation of the abscess did not yield any microbes. Conclusion Infected Intradural DC with complete dermal sinus is a rare type. Radical neurosurgical treatment of DC and dermal sinus associated with antibiotics should be planned early to prevent infections such as abscess and meningitis.

Thunderclap Headache Due to Ruptured Intracranial Dermoid Cyst

Thunderclap Headache Due to Ruptured Intracranial Dermoid Cyst

Atypical imaging features of posterior fossa's dermoid cyst: Case report and review of literature

Background:Intracranial dermoid cysts are uncommon lesions with characteristic imaging appearances. Symptomatic clinical presentation usually occurs in one of two ways: mass effect or rupture. Radiologically, dermoid cysts typically present as low density masses on computed tomography (CT) scan and are generally hyperintense on T1-weighted magnetic resonance imaging (MRI) sequences with variable signal on T2-weighted sequences.Case Description:We present the case of a 35-year-old female presented with symptoms of increased intracranial pressure. Radiological investigations showed a cystic posterior fossa tumor that was not only hyperdense on CT scans but also hypointense on MRI T1-weighted images. The patient underwent a total-gross resection of an extra-parenchymal posterior fossa tumor. Pathologic examination of the specimen concluded to dermoid cyst.Conclusion:Dermoid cyst of the posterior fossa is a benign lesion surgically treatable. Only an appropriate radiological diagnosis of this lesion would permit a well-targeted therapeutic approach.

Ruptured intracranial dermoid cysts: a pictorial review.

Intracranial dermoid cysts are rare, benign, congenital, slow-growing cystic lesions. They are composed of mature squamous epithelium and can contain apocrine, eccrine, and sebaceous glands as well as other exodermal structures. Rupture of intracranial dermoid cysts is a relatively uncommon phenomenon but can cause more serious complications such as chemical meningitis, vasospasm, and cerebral infarction. Understanding of the appearance of both unruptured and ruptured dermoid cysts on computed tomography and MRI, especially awareness of existing low signal “blooming artefacts” on certain sequences, aids diagnosis and referral to the proper specialty for appropriate treatment.

Quiste dermoide intracraneal con rotura espontánea. Reporte de caso

Introducción: Los quistes dermoides son tumores raros, que se originan por la inclusión de elementos de origen ectodérmico en el momento del cierre del tubo neural durante la embriogénesis. Su contenido incluye una variedad de derivados del ectodermo como glándulas apocrinas, sudor, quistes sebáceos, folículos pilosos, epitelio escamoso y dientes. Los síntomas que generan estos tumores benignos son tanto por el efecto de masa sobre las estructuras neurovasculares adyacentes (cefalea, convulsiones, hidrocefalia, isquemia), como por la irritación meníngea en los casos de ruptura hacia el espacio subaracnoideo. Objetivo: Presentar el curso clínico de paciente femenino de 21 años de edad, que acude a la consulta de neurocirugía con clínica de cefalea y síncope. Presentación del caso: Paciente con rotura espontánea de un quiste dermoide intracraneal que consultaba previamente por clínica de cefalea, a la cual se asocia más recientemente episodios de alteración de la conciencia, realizándose estudio de neuroimágenes con evidencia de quiste dermoide intracraneal roto, el cual fue manejado quirúrgicamente con resolución exitosa de la sintomatología. Conclusiones: Se considera relevante el caso teniendo en cuenta lo inusual de la patología según la epidemiología consultada, además este reporte de caso, permite sensibilizar al personal de salud sobre esta patología tumoral la cual puede llegar a la cura en caso de resección quirúrgica completa, con resolución de la clínica.

Ruptured dermoid cyst consisting of two adjacent masses with different components in the middle and posterior cranial fossa

Intracranial dermoid cysts are among the rarest tumors, and cases of rupture are even rarer. Dermoid cysts present great variety of radiographic features depending on their origin, which may make the diagnosis difficult. A 17-year-old female complained of headache and nausea. Magnetic resonance imaging (MRI) showed two masses in the right middle cranial fossa and in the posterior fossa, which had different components according to their locations. Additionally, we observed fatty droplets in the subarachnoid space on MRI. We resected the tumor, and the postoperative diagnosis was ruptured dermoid cyst. There was continuity between both masses, indicating these were from the same tumor. We experienced a rare case of ruptured dermoid cyst which presented as two adjacent lesions in the middle cranial fossa and posterior cranial fossa. The main components of the tumor were significantly heterogeneous depending on the lesion site.

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

Objective Dermoid cysts are benign, congenital malformations that account for ∼0.5% of intracranial neoplasms. The authors describe a 42-year-old female with a prepontine dermoid cyst who underwent apparent gross total resection (GTR) but experienced cyst recurrence. To date, very few cases of prepontine dermoid cysts have been reported. The prevalent region where these cysts are located can be difficult to determine. In addition, the authors systematically review the literature to characterize the clinical presentation, anatomical distribution, and surgical outcomes of intracranial dermoid cysts. Design Systematic review. Setting/Participants PubMed, Web of Science, and Scopus databases. Main Outcome Measures Extent of resection, symptom improvement, and recurrence rates. Results A total of 69 patients with intracranial dermoid cysts were identified. Three (4.3%) intracranial dermoid cysts were located in the prepontine cistern. The average age of patients was 33.3 years. The most common presenting symptoms were headache (52.2%) and visual disturbances (33.3%). Intracranial dermoid cysts were distributed similarly throughout the anterior, middle, and posterior cranial fossae (29.0%, 36.2%, and 29.0%, respectively). GTR was achieved in 42.0% of cases. Thirty-four (49.3%) patients experienced symptom resolution. Recurrence rate was 5.8% at a mean follow-up of 2.1 years. Conclusions Intracranial dermoid cysts most often present as headaches and visual disturbances. Intracranial dermoid cysts were found in the anterior, middle, and posterior cranial fossae at similar frequencies but with clear predilections for the Sylvian fissure, sellar region, and cerebellar vermis. Outcomes following surgical excision of intracranial dermoid cysts are generally favorable despite moderate rates of GTR.

Ruptured intracranial dermoid: Case report and literature review

Intracranial dermoid cysts are nonneoplastic, ectodermal inclusion cysts of embryological origin. They contain various ectodermal derivatives including apocrine glands, sebaceous glands, hairs, squamous epithelium, and occasionally teeth. Spontaneous rupture of these cysts is uncommon, and so far very few cases have been reported in the literature. Hereby, we report a case of young male presenting with ruptured intracranial dermoid cyst managed surgically.

Unruptured Intradiploic Dermoid Cyst with Incomplete Dermal Sinus overlying Torcular Haerophili in an Adult Woman: Uncommon Location for Uncommon Lesion

Dermoid Cysts are rare lesions, accounting for about 1% of intracranial neoplasms, that involve mainly pediatric population; among the etiopathogenetical hypotheses there is an abnormal entrapment of the cells of the epithelial ectoderm in the neuroectoderm at the time of the closing of the neural tube. We report a rare case of simptomatic Dermoid Cyst with incomplete dermal sinus, placed on posterior cranial fossa overlying Torcular Haerophili, in a 33 year old woman, which has been treated surgically. We highlight the particular onset area of the lesion, its rise not in pediatric but in adult age and the lack of adhesion between the lesion and the surrounding tissues, whereas it frequently occurs in intracranial Dermoid Cysts. We express besides the necessity of surgical therapy even in absence of acute symptomatology, due to the risk of rupture and/or infection typical of such lesions.

Electroconvulsive therapy for medication-refractory depression in a patient with ruptured intracranial dermoid cyst, meningioma, and neurofibromatosis.

Electroconvulsive therapy (ECT) is considered relatively contraindicated in patients with intracranial space-occupying lesions. A 53-year-old male presented with a 5-year history of medication-refractory major depressive disorder. Brain imaging findings suggested the presence of a ruptured dermoid cyst in the transverse sinus and a calcified meningioma in the temporal lobe sulcal space. There was no evidence of mass effect. Neurofibromatosis was the only other clinical condition present. The patient had no clinical neurological deficits. Since the depression was severe and he was suicidal, ECT was advised. There was a substantial improvement after four bilateral and then eight right unilateral brief-pulse ECTs administered on alternate days, thrice weekly. There were no complications associated with ECT. The treatment gains were maintained with maintenance antidepressant medication at a 1-year follow-up. This is probably the first reported case of the use of ECT in a medication-refractory, severely depressed patient with a ruptured intracranial dermoid cyst and with a calcifying meningioma. The results testify to the safety of ECT even in high-risk patients.

A “Logarithmic Spiral” in the Brain: Images of an Intracranial Dermoid Cyst

A logarithmic spiral is a self-similar spiral curve, which often appears in nature, e.g., mollusk shells. In the normal tissues of the human body, the cochlea is also an approximate logarithmic spiral. However, approximate logarithmic spirals are rarely, if ever, reported in tumors. Recently, we treated a 26-year-old woman with a one-year history of headache. Preoperative magnetic resonance imaging showed a possible brain tumor with radiological characteristics similar to a typical logarithmic spiral, which has seldom been observed before. Because of the obvious clinical symptoms and discomfort, as well as the possible presence of an intracranial tumor, we performed a craniotomy and tumor resection. Perioperatively, we found an intact tumor capsule, with contents that appeared like egg-drop soup mixed with hairs. A postoperative pathological diagnosis of a dermoid cyst was made. However, more interestingly, the logarithmic spiral could be described mathematically with a high goodness of fit. In this paper, we present this case with various clinical images.

Ruptured Intracranial Dermoid and the Chemical Shift Artifact

Ruptured Intracranial Dermoid and the Chemical Shift Artifact

Ruptured intracranial dermoid cyst

A man in his late 60s presented with a sudden-onset headache, left-sided weakness and seizures. An unenhanced CT of the head showed a large low-attenuation lesion in his right frontal...