Lipid Droplets in the Basal Cistern and Ventricles.

A 34-year-old man complained of left-side headache lasting for a week. He had no fever or meningeal sign. Brain computed tomography (CT: window level, 20; window width, 250) revealed hypodense (average CT value: -98HU, indicating lipid) lesions in the basal cistern (Picture A) and ventricles (Picture B). These were hyperintense on T1-weighted magnetic resonance imaging (MRI) (Picture C, D). Based on these and the CT results, we concluded that the lesions were lipid droplets. The cerebrospinal fluid showed no pleocytosis. The patient had undergone a surgery for lumbar meningocele at a newborn. Lumbar MRI showed the existence of an intrathecal dermoid cyst (Picture E, F). The lipid droplets might have arisen from the dermoid cyst, although the timing could not be determined. The patient's headache was resolved with analgesics. These unusual findings are observed in cases of chemical meningitis due to rupture of a spinal dermoid cyst (1).

Picture.

The authors state that they have no Conflict of Interest (COI).