Lipid Droplets in the Basal Cistern and Ventricles

Maeda, Kengo; Inoue, Akitoshi; Hirano, Shingo; Sugihara, Yoshiko

doi:10.2169/internalmedicine.0851-18

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“…Management for patients who present with meningism has been significantly underreported. Of the 9 cases presenting with meningism included in this review, only 2 patients (including ours) reported the use of analgesics to treat this complication to achieve symptom relief, 19 whereas 1 reported the use of intravenous antibiotics. 21 However, the administration of systemic steroids in this context should also be considered because it has been reported to ameliorate the transient chemical meningitis symptoms experienced after intracranial dermoid cyst rupture.…”

Section: Discussionmentioning

confidence: 96%

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Traumatic sacral dermoid cyst rupture with intracranial subarachnoid seeding of lipid particles: illustrative case

Perdomo‐Pantoja

Zakaria

Judy

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Intracranial deposits of fat droplets are an unusual presentation of a spinal dermoid cyst after spontaneous rupture and are even more uncommon after trauma. Here, the authors present a case with this rare clinical presentation, along with a systematic review of the literature to guide decision making in these patients. OBSERVATIONS A 54-year-old woman with Lynch syndrome presented with severe headache and sacrococcygeal pain after a traumatic fall. Computed tomography of the head revealed multifocal intraventricular and intracisternal fat deposits, which were confirmed by magnetic resonance imaging (MRI) of the neuroaxis; in addition, a ruptured multiloculated cyst was identified within the sacral canal with proteinaceous/hemorrhagic debris, most consistent with a sacral dermoid cyst with rupture into the cerebrospinal fluid (CSF) space. An unruptured sacral cyst was later noted on numerous previous MRI scans. In our systematic review, we identified 20 similar cases, most of which favored surgical treatment. LESSONS Rupture of an intraspinal dermoid cyst must be considered when intracranial fat deposits are found in the context of cauda equina syndrome, meningism, or hydrocephalus. Complete tumor removal with close postoperative follow-up is recommended to decrease the risk of complications. CSF diversion must be prioritized if life-threatening hydrocephalus is present.

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Section: Discussionmentioning

confidence: 96%

“…Although the rupture of spinal dermoids is well known, 7,8 only a few cases have actually documented distant intracranial fat deposits. 6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Here, we illustrate an uncommon presentation of a sacral dermoid cyst. After traumatic rupture, it released fat droplets into the lumbar cistern.…”

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confidence: 99%