Abstract
Dermoid cysts are rare, congenital cystic tumours that compose < 0.5% of primary intracranial tumours. They derive from embryonic ectodermal tissue during neural tube closure, and are usually located in the midline or parasagittal region of the skull, although their most common location is the spinal canal.
Rupture into the subarachnoid spaces and ventricles is extremely rare, which may occur spontaneously or after closed-head trauma. Tumour rupture may be asymptomatic or give rise to recurrent chemical meningitis due to spillage of its contents into the subarachnoid space and ventricular system, manifesting with seizures, vasospasm with cerebral infarction and death.
We report a 47-year-old male patient who presented with a sudden onset of severe headache, accompanied by nausea and vomiting without disturbed consciousness. The patient was progressively worsening. On admission, body temperature was 37.8 C, and the patient's vital signs were within normal limits. A CT scan demonstrated a hypodense lesion, and T1-weighted MRI scans revealed a round hyperintense lesion in the left frontal horn, with dilated ventricles, compatible with an intraventricular rupture of a left frontal horn dermoid cyst. There was also significant hydrocephalus. Successful surgical intervention followed, resulting in the complete removal of the cyst and the patient's subsequent full recovery with the resolution of symptoms. In this case, we are reporting on the management of a case of intraventricular ruptured dermoid cyst and reviewing the literature.
