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January 1978

Ruptured Intraventricular Dermoid Cyst Without Clinical Inflammation

Author Affiliations

Div of Neurosurgery Medical College of Pennsylvania Philadelphia, PA 19129
Dept of Radiology Pennsylvania Hospital Philadelphia, PA 19107

Arch Neurol. 1978;35(1):61. doi:10.1001/archneur.1978.00500250065021

To the Editor.—  It is widely thought that a severe inflammatory response ensues if the contents of a dermoid or epidermoid cyst escape into the ventricles or subarachnoid pathways.1 We would like to describe a man who, despite intraventricular-free oil from a dermoid cyst, both preoperatively and postoperatively, failed to manifest any clinical evidence of inflammation.

Report of a Case.—  This 56-year-old man had had a progressive ataxia and mentalComputerized tomogram, demonstrating free oil in the left lateral ventricle. deterioration without headache for four years. General health appeared good, but he was grossly demented. There was no papilledema and he had a mild left hemiparesis and an ataxic gait. His neck was supple and he was afebrile. The white blood cell count was 8,100/cu mm and sedimentation rate was 5 mm/hr (Westergren). Roentgenograms showed calcification in the right parasellar area. Computerized tomography disclosed hydrocephalus involving all ventricles. Free

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