MR Imaging of Ruptured Intracranial Dermoid

Traumatic rupture of an intracranial dermoid cyst

“…3 Typical radiological findings for a ruptured intracranial dermoid cyst are the fat signals in the subarachnoid space on MRI, which have high signal intensities in T 1 -weighted images and low in T 2 -weighted images. 1,4,5 In our case, we performed an additional fat suppression sequence with gadolinium-enhanced MRI, and found that the fat droplets that had high signal intensities in T 1 -weighted images were not present in this sequence. We confirmed that the cyst had ruptured, and hypothesized that the meningeal irritation was due to chemical meningitis, so steroid therapy was initiated immediately on presentation.…”

Tetraventricular hydrocephalus due to ruptured intracranial dermoid cyst

“…Rupture of intracranial dermoids can occur in the subarachnoid spaces or in the ventricles. The spillage of the keratin and cholesterol breakdown products can generate variable clinical symptoms such as headache, dementia, seizures, loss of strength, or transient cerebral ischemia [1,2,3,4,5]. A chemically induced meningitis and chronic arachnoiditis frequently follow dermoid rupture with variable clinical sequela.…”

“…The advent of CT and MR imaging have significantly increased the preoperative detection of dermoid cysts and their complications [1,2,3,4,5,6,7,9]. MR imaging is more sensitive than CT for detection of the dermoid cyst and its complications by the advantage of much higher contrast resolution, the ease of multiplanar imaging and the lack of bone artifacts [9].…”

“…Magnetic resonance imaging is also more useful than CT scans in differentiation of dermoids from epidermoids based on different T1 and T2 relaxation times. Free fat globules with widening of sulci are characteristic on CT and MR images [1]. Since hyperintense fat contrasts to hypointense cerebrospinal fluid, the spread of the liquid contents of the dermoid is more conspicuous on T1-weighted MR images.…”

Ruptured Intracranial Dermoid Tumor Secondary to Closed Head Trauma

“…Intracranial dermoid cysts comprise 0.4 to 1.5% of all intracranial tumors. They are typically found in the suprasellar region and in the posterior fossa [4][5][6][7]. Intracranial dermoids have ruptured spontaneously and during or following surgery.…”