A case of DC with intracranial extension in a 9-year-old boy who presented with headache and a fluctuant scalp swelling. Magnetic resonance imaging revealed a midline scalp mass with intracranial extension. The lesion was excised with superior sagittal sinus preservation; and confirmed as DC by histopathological examination. The boy made a good recovery
((Ahmed S, Dutta D, Biswas T, Paul SP. Dermoid Cyst with Intracranial Extension Presenting With Headache. Mymensingh Med J. 2021 Jul;30(3):860-862. PMID: 34226481.)).
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Borni et al.  from the Department of Neurosurgery - UHC Habib Bourguiba -Sfax ([[Tunisia]]), presented a rare case of a spontaneously ruptured intracranial [[dermoid cyst]] in a 32-year-old man presenting as new onset epileptic [[seizure]]s due to [[chemical meningitis]] caused by dissemination of fat or lipid droplets
((Borni M, Abdelhedi A, Kammoun B, Kolsi F, Boudawara MZ. Ruptured central
nervous system dermoid cyst of the suprasellar region manifesting as unusual
epileptic seizure: a case report. World Neurosurg. 2018 Nov 2. pii:
S1878-8750(18)32451-3. doi: 10.1016/j.wneu.2018.10.153. [Epub ahead of print]
PubMed PMID: 30395941.
)).
===2013===
A patient complaining of vertigo caused by spontaneous rupture of dermoid cyst, preoperatively diagnosed by CT and MRI. Cranial CT revealed a dense fatty lesion adjacent to the posterolateral parasellar region on the left with multiple small, dense fat droplets scattered in the subarachnoid space corresponding to a dermoid cyst rupture. Cranial MRI sections revealed a lesion with mixed-signal-intensity and multiple hyperintense droplets scattered through the cerebellar surface on the left. No enhancement was found on axial T1-weighted MRI after intravenous Gadolinium administration. Diffusion weighted image (DWI) and apparent diffusion coefficient map studies exhibited explicit restricted diffusion.

Many studies and literature case reports concerning the rupture of dermoid cyst have been reported. However, multimodal imaging of this rare pathology in the same patient is uncommon. Although dermoid cysts are pathognomonic in appearance on a CT examination, the MRI is also of value in helping to understand the effect of extension and pressure of the mass. DWI is also important for support of the diagnosis and patient follow-up
((Asil K, Gunduz Y, Ayhan LT, Aksoy YE, Yildiz C. Spontaneous rupture of
intracranial dermoid tumor in a patient with vertigo. Computed tomography and
magnetic resonance imaging findings. Pol J Radiol. 2013 Oct;78(4):79-82. doi:
10.12659/PJR.889172. Epub 2013 Nov 19. PubMed PMID: 24505228.)).
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A 47-year-old female presented to the hospital with a ruptured intracranial dermoid cyst following a mild head injury. The ruptured cyst contents were disseminated into the subarachnoid and intraventricular compartments, resulting in an obstructive hydrocephalus. After medical stabilization, she underwent gross total resection of the cyst using combined transsylvian, transcortical-transventricular, and sub-frontal approaches. A ventriculo-peritoneal shunt was eventually also needed.

Traumatic rupture of an intracranial dermoid cyst is an extremely rare event and this is only the fourth such case reported in the literature. The authors presume that this rupture occurs due to sudden shifts in the cyst sac, which is adherent to some partially mobile intracranial contents. Although computed tomography (CT) is often adequate in making a diagnosis of this entity, magnetic resonance imaging (MRI) provides complete characterization of the extent of lipid dissemination, and is essential for operative planning. Intravenous steroids at presentation are helpful in managing the aseptic meningitis associated with rupture. Complete surgical resection is the goal, but must be weighed against the risk for injury to nearby vital structures. Hydrocephalus should be managed promptly, and patients should be monitored for it closely in the perioperative period. Even though the recurrence rate with subtotal resection is extremely rare, follow up should be done routinely
((Esquenazi Y, Kerr K, Bhattacharjee MB, Tandon N. Traumatic rupture of an
intracranial dermoid cyst: Case report and literature review. Surg Neurol Int.
2013 Jun 12;4:80. doi: 10.4103/2152-7806.113357. Print 2013. PubMed PMID:
23869280; PubMed Central PMCID: PMC3707326.
)).