Rupture of a Spinal Dermoid Cyst May Lead to Dissemination and Progress of Fatty Tissue in the Central Spinal Canal and Intracranial Subarachnoid Space

Kabbasch, Christoph; Dorn, Franziska; Mpotsaris, Anastasios; Weber, Christoph; Liebig, Thomas

doi:10.15274/nrj-2014-10089

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…If there are disseminated intracranial lipid droplets in brain MRI, full spinal imaging should be performed to search for a ruptured dermoid cyst . Acute common symptoms are headache, seizure, and chemical meningitis . Our patient had headache 7 days after back pain, presumably due to cyst rupture.…”

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confidence: 74%

Delayed Severe Headache Due to Ruptured Spinal Dermoid Cyst

et al. 2017

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A 42-year-old man without any underlying disease consulted our neurology department for fever and severe headache. His body temperature was 37.88C. Seven days prior, he was admitted to a urology department with acute severe bilateral flank/lower back pain, voiding difficulty, and fever. Upon admittance, urinary analysis was revealed as normal, and computed tomography urography was unremarkable except for butterfly vertebra at L5 ( Fig. 1A). At the time of admission, he did not have headache, but 7 days later, new-onset progressive headache developed. The headache was throbbing in nature, generalized, with an intensity of 6/10. Neck stiffness was present, but the rest of the neurologic examination was normal. Brain CT and MRI showed multiple lipid droplets in the lateral ventricle, quadrigeminal, interpeduncular, suprasellar, superior cerebellar cistern, and both cerebral fissures (Fig. 1B). Therefore, lumbar spine MRI was performed to screen for ruptured dermoid cyst, which were found at the L4/5 level (Fig. 1C). Consequently, he was operated with laminectomy and near total excision of the lesion. Pathology confirmed dermoid cyst (fat tissue, cystic lesion lined with squamous epithelium, and skin adnexa with hair fragments). Finally, headache resolved within 7 days after surgery. Low back pain and voiding difficulty completely disappeared by a follow-up conducted after 7 months.Spinal dermoid cysts are benign, slowly growing tumors without apparent symptoms until adulthood. 1 Disseminated intracranial lipid droplets from ruptured spinal dermoid tumors are very rare. 1 Fat material has intrinsic T1 hyperintensity on MRI. The T1

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confidence: 74%

Delayed Severe Headache Due to Ruptured Spinal Dermoid Cyst

et al. 2017

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“…The patient's headache was resolved with analgesics. These unusual findings are observed in cases of chemical meningitis due to rupture of a spinal dermoid cyst ( 1 ).…”

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confidence: 93%

Lipid Droplets in the Basal Cistern and Ventricles

et al. 2018

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“…The migration of fat droplets into the subarachnoid space after craniotomy [9][10][11], spinal trauma [12][13][14], baclofen pump insertion [15], and rupture of intracranial [16][17][18][19][20] or intraspinal canal dermoid cysts [21,22] has been previously described. Recently, two cases of obstructive hydrocephalus due to Sylvian aqueduct obstruction with fat droplets after craniotomy were reported [23,24].…”

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confidence: 99%