Ruptured cerebral epidermoid cyst : A rare cause of chronic headache

Intracranial epidermoid cysts are rare, benign congenital tumors of the central nervous system that originate from ectodermal inclusions during embryogenesis. This case describes a spontaneous rupture of an epidermoid cyst in a 53-year-old male patient who presented with severe, treatment-resistant headaches. Diagnosis was confirmed through non-contrast computed tomography (CT), and magnetic resonance imaging (MRI) which showed an extra-axial lesion with fat density and lipid droplet dissemination within the subarachnoid spaces. Surgical resection was performed, and the patient had a favorable postoperative outcome. Although rare, rupture of an epidermoid cyst with lipid dissemination is a clinically significant event with characteristic imaging features; early recognition on computed tomography (CT) and MRI is essential for accurate diagnosis and timely management.