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Epidermoid cysts are formed by ectopic growth and cystic expansion of epithelium. In the CNS, congenital epidermoids are most commonly found near midline structures, reflecting their genesis from incomplete cleavage of ectoderm. In contrast, most acquired epidermoids occur closer to surface structures. The most well known example occurs following lumbar puncture with the inadvertent transplantation of epithelial tissue into the thecal sac.1,2 Less well recognized is the potential for intracranial development of epidermoid cysts following penetrating head trauma. Here we report a patient who developed a large epidermoid cyst at the site of a skull fracture incurred 23 years earlier. Development of this cyst was temporally associated with the development of a severe recurrent headache.
Case report.
A 45-year-old man presented to the emergency room with a complaint of severe unremitting headache. The patient had penetrating trauma to the skull during an assault 23 years earlier. At that time he underwent a right frontoparietal craniectomy and cranioplasty with …
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