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Table of Contents    
COMMENTARY
Year : 2018  |  Volume : 66  |  Issue : 4  |  Page : 1200

Rupture of spinal dermoid cyst with intracranial dissemination


Department of Neurosurgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

Date of Web Publication18-Jul-2018

Correspondence Address:
Dr. Dattatraya Muzumdar
Department of Neurosurgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.237017

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How to cite this article:
Muzumdar D. Rupture of spinal dermoid cyst with intracranial dissemination. Neurol India 2018;66:1200

How to cite this URL:
Muzumdar D. Rupture of spinal dermoid cyst with intracranial dissemination. Neurol India [serial online] 2018 [cited 2018 Aug 17];66:1200. Available from: http://www.neurologyindia.com/text.asp?2018/66/4/1200/237017




Spinal dermoid cysts are usually asymptomatic and rarely present with symptoms of rupture or dissemination. They commonly present with motor, sensory or sphincter involvement. The treatment in such cases is usually straightforward. Following resection of the tumor, there is almost complete resolution of symptoms. However, if there is a rupture of the dermoid cyst and spillage of contents into the spinal canal as well its ascent into the intracranial subarachnoid space and ventricular system, it results in chemical meningitis, which can have disastrous consequences resulting in morbidity and mortality.[1],[2],[3] The formidable challenge occurs when a patient develops aseptic meningitis with no evidence of a mass lesion in the cranium. In such a situation, a spinal magnetic resonance imaging (MRI) should be performed to exclude a spinal dermoid cyst. The routine use of MRI has increased the detection of this entity, and the diagnosis of droplets on MRI is standardized. The present case highlights the above fact. The male preponderance and the upper dorsal location are the salient features. The authors have also grouped these lesions into three categories, viz. Type I – symptomatic spinal–symptomatic cranial, Type II – symptomatic spinal–asymptomatic cranial and Type III – asymptomatic spinal–symptomatic cranial. Safe excision of the lesion is paramount to prevent any additional neurological deficits. Ventriculoperitoneal shunt may be necessary in symptomatic progressive hydrocephalus. The long-term prognosis of intracranial fat dissemination with regard to symptom recurrence and radiological resolution remains unknown.



 
  References Top

1.
Venkatesh S K, Phadke R V, Trivedi P, Bannerji D. Asymptomatic spontaneous rupture of suprasellar dermoid cyst: A case report. Neurol India 2002;50:480  Back to cited text no. 1
    
2.
Rai SP. Ruptured intracranial dermoid cyst. Neurol India 2009;57:98-9.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Vyas S, Giragani S, Singh P, Khandelwal N. Ruptured spinal dermoid with central canal and intraventricular extension. Neurol India 2010;58:678-9.  Back to cited text no. 3
[PUBMED]  [Full text]  




 

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