History of Headaches

28-year-old male presents with history of headaches.

Figure 1. Sagittal T1 weighted image shows well-defined suprasellar lesion with mixed signal intensity. Some small foci of high signal in the subarachnoidal space.

Figure 2. Axial T2 weighted image shows a well-defined lesion with predominantly high signal intensity. No apparent reaction in adjacent brain parenchyma.

Figure 3. Coronal FLAIR shows well-defined lesion with predominantly low signal intensity.

Figure 4. Axial gradient echo image shows lesion with mixed signal, but with predominantly low signal intensity.

Figure 5A and B. DWI shows scattered high signal in B1000 image but, no real diffusion restriction on ADC map.

Figure 6. Coronal T1 weighted image shows small foci of high signal in the Sylvia fissure.

Figure 7. Axial gradient echo shows small area of low signal in the right frontal horn.

Diagnosis: Ruptured dermoid cyst

Rupture can be spontaneous or a result of a head trauma. Surgery is often warranted.