Intracranial lipomas: importance of localization

Area of Science:

• Neuroradiology
• Congenital Malformations
• Neuroimaging

Background:

• Intracranial lipomas are rare congenital malformations, typically asymptomatic midline lesions.
• Associated brain malformations frequently occur with intracranial lipomas.
• Most intracranial lipomas are incidentally discovered during neuroradiological investigations.

Purpose of the Study:

• To describe imaging findings of intracranial lipomas using CT, MR, and MR angiography.
• To review the literature on intracranial lipomas and associated malformations.
• To discuss the frequency and spectrum of associated brain malformations.

Main Methods:

• Retrospective review of CT and MR findings in 24 patients diagnosed with intracranial lipoma.
• Measurement of CT density and description of morphological findings and associated anomalies.
• Analysis of lipoma locations, including pericallosal, sylvian fissure, and quadrigeminal cistern.

Main Results:

• Intracranial lipomas were located in various regions, with pericallosal and dorsal mesencephalic being preferential sites.
• Associated anomalies were observed in 6 out of 24 patients.
• All patients with sylvian fissure lipoma experienced seizures, highlighting its association with epilepsy.

Conclusions:

• CT and MR imaging are crucial for diagnosing intracranial lipomas due to their characteristic imaging features.
• Associated pathologies, such as midline anomalies and aneurysms, frequently accompany intracranial lipomas and necessitate thorough radiologic assessment.
• Sylvian fissure lipomas should be considered in the differential diagnosis for patients presenting with epilepsy.