Ruptured Intra-axial Dermoid Cyst of Brain

Dermoid cysts are rare intra-cranial tumors commonly located in the subarachnoid spaces. Intra-axial dermoid cysts are even rarer. Intracranial dermoid cysts are generally slow-growing and benign; symptoms result from the mass effect of these cysts. Rupture of intracranial dermoid with spillage of its contents into subarachnoid space and//or ventricles can lead to chemical meningitis, hydrocephalus, seizures, cerebral ischemia and infarction. Very rarely rupture may not be associated with any symptoms. We here present a case of spontaneous rupture of an intra-axial dermoid cyst in an adult patient that presented with headache and was diagnosed on the basis of dramatic appearance of intraventricular and cisternal fat droplets along with parenchymal fat containing lesion on CT and MRI.