Ruptured intracranial dermoid cyst in a child. Cause of atypical neurological symptoms

Intracranial dermoid cysts are uncommon lesions with characteristic imaging appearances. Although they are characterized by slow growth rate, they are often associated with serious complications due to the location and pressure of the adjacent structures. Rarely, rupture of dermoid cysts in the CNS can cause a variety of clinical presentation that vary from no symptoms to sudden death. We report a case of spontaneously ruptured intracranial dermoid cyst in a 10-year-old boy, who presented due to daily partial seizures, strabismus, unilateral eyelid drooping, headaches, walking abnormalities and poor school performance, with progressive deterioration in the past two years. Brain MRI was performed, which led to the diagnosis. Partial surgical removal and VP shunting was placed and anticonvulsant therapy was started. Two years after diagnosis, our patient has neurological deficits. Diplopia and eyelid drooping as well as unsteady gait still consist disability.