|Year : 2018 | Volume
| 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 Publication||18-Jul-2018|
Dr. Dattatraya Muzumdar
Department of Neurosurgery, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Muzumdar D. Rupture of spinal dermoid cyst with intracranial dissemination. Neurol India 2018;66:1200
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.,, 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.
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