Intracranial Epidermoid Lesions: Our Experience of 38 Cases

To describe a case series evaluating the clinical presentation and outcome following surgery in patients diagnosed with these lesions.

A retrospective study conducted over a 4-year period.

A total 38 patients who underwent surgery for intracranial epidermoid lesions were identified. Of these, 20 were supratentorial and 18 were infratentorial lesions. Thirty-three patients presented with headache. Ten patients with supratentorial lesions presented with seizures. Patients with suprasellar epidermoid lesions presented with headache and visual problems. Fourteen of the 18 patients with cerebellopontine angle lesions presented with symptoms of trigeminal neuralgia. Postoperatively, 3 patients with cerebellopontine angle tumors developed facial weakness which was transient in 2 patients but permanent in 1 patient. Visual impairment in patients with suprasellar epidermoid lesions improved postoperatively. Hormonal replacement therapy was required in 2 patients. Recovery of 4 patients was complicated by cerebrospinal fluid leak while meningitis developed in 2 patients. One patient operated for cerebellopontine angle epidermoid died postoperatively.

Epidermoid lesions can develop anywhere in the cranial cavity. Like other space occupying lesions they often present with symptoms of raised intracranial pressure and with specific neurological deficits depending on location of the tumor. Surgical outcome is excellent with low complication rates.