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Wax Droplets Lining Ventricles
Sushanta K Sahoo1, Sivashanmugam Dhandapani1, Lomesh Wankhede1
1Department of Neurosurgery, PGIMER, Chandigarh, India.
World Neurosurgery
|May 4, 2019
Summary
A rare spinal dermoid rupture caused obstructive hydrocephalus in an adult male. Treatment with cerebrospinal fluid diversion led to symptom improvement, with the spinal lesion remaining asymptomatic.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Spinal dermoid tumors are rare congenital tumors.
- Rupture of spinal dermoid tumors can lead to intracranial fat deposition and neurological complications.
Observation:
- A 42-year-old male presented with acute headache and vomiting, indicative of obstructive hydrocephalus.
- Fundus examination revealed papilledema, and MRI confirmed ventriculomegaly with aqueductal obstruction and intracranial fat deposits.
Findings:
- Spinal MRI identified a lumbar intramedullary lesion with T1, T2 hyperintense signals, consistent with a ruptured dermoid tumor.
- The patient underwent endoscopic third ventriculostomy for hydrocephalus management.
Implications:
- Silent rupture of spinal dermoid tumors can present with severe neurological symptoms like obstructive hydrocephalus.
- Cerebrospinal fluid diversion is an effective treatment, and patients may remain asymptomatic regarding the primary spinal lesion.
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