Asymptomatic traumatic rupture of an intracranial dermoid cyst: A case report

Abstract

BACKGROUND

Previous studies reported that most of the intracranial dermoid cyst ruptures were spontaneous, and only a few were traumatic, with asymptomatic much rarer than the symptomatic ruptures. Hence, how to deal with the asymptomatic traumatic rupture of intracranial dermoid cyst remains a challenge in the clinic.

CASE SUMMARY

A 59-year-old man was accidentally diagnosed with intracranial dermoid cyst through a cranial computed tomography (CT) scan due to a car accident. A mixed-density lesion with fat and a calcified margin was observed in the midline of the posterior fossa, accompanied with lipid droplet drifts in brain sulci, fissures, cisterns, and ventricles. After 1 wk of conservative observation, no change was observed on the updated cranial CT scan. After 2 wk of conservative observation, magnetic resonance imaging examination confirmed that the lesion was a traumatic rupture of a posterior fossa dermoid cyst with lipid droplet drifts. As the patient exhibited no adverse symptoms throughout the 2 wk, a 6-mo follow-up visit was arranged for him instead of aggressive treatment. Nonetheless, the patient did not show any abnormal neurological symptoms in the 6 mo of follow-up visits.

CONCLUSION

Asymptomatic traumatic rupture of intracranial dermoid cyst could be just followed or treated conservatively rather than treated aggressively.

Keywords: Intracranial dermoid cyst; Magnetic resonance imaging; Computed tomography; Rupture; Traumatic; Case report

Core Tip: A case of traumatic intracranial dermoid cyst rupture in a 59-year-old man was analyzed retrospectively. Imaging findings, clinical manifestations, treatment, and follow-up results for 6 mo were collected. Combined with the relevant literature, the cause and treatment of asymptomatic cyst rupture were analyzed. For a traumatic intracranial dermoid cyst rupture, if the lesion is small, affects the adjacent structures only slightly, and has few lipid droplet drifts, conservative treatment or only follow-up visits could be adopted according to the patient’s neurological examination results.