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      Quadrigeminal cistern lipoma.

      Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

      Adult, Akinetic Mutism, etiology, physiopathology, Brain, pathology, radiography, Brain Neoplasms, diagnosis, Cerebellum, Corpus Callosum, Decompression, Surgical, Endoscopy, Female, Headache, Humans, Intracranial Hypertension, Lipoma, Magnetic Resonance Imaging, Neurosurgical Procedures, Subarachnoid Space, Tectum Mesencephali, Tomography, X-Ray Computed, Treatment Outcome, Vomiting

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          Abstract

          Intracranial lipomas are rare benign congenital neoplasms accounting for 0.1 to 0.5% of all primary brain tumours. Approximately 50% are associated with other cerebral developmental disorders. These slow growing benign lesions are usually asymptomatic and rarely require surgery. We report the case of a 37 year old woman presented with signs of raised intracranial pressure. Computerized tomography and magnetic resonance imaging demonstrated a quadrigeminal cistern lipoma compressing the aqueduct of Sylvius. The patient underwent surgery and a distinct plane of cleavage between the lipoma and the adjacent neural structures was found, allowing total removal of the lesion. Postoperatively, the patient was relieved of her original symptoms but developed akinetic mutism which lasted for two weeks. Intracranial lipomas rarely become symptomatic and surgery is seldom required. If the lesion progresses and causes symptoms of raised intracranial pressure or compression of neural structures, surgical intervention is indicated. Total removal should not be attempted unless a plain of cleavage between the lesion and adjacent neural structures is present. Surgical manipulation should be minimised to avoid complications.

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          Journal
          15936197
          10.1016/j.jocn.2004.08.015

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