OpenHealth Q&A

Should I Reassess My Past Imaging Results? Insights on Intracranial Lipoma or Ruptured Dermoid

**Patient Profile:** M32, height 6'3", weight 225 lbs. No current medications or reported health issues. Recently, while examining some old medical files, I stumbled upon a CT scan report from 15 years ago, conducted after I suffered a concussion that resulted in persistent headaches. This imaging was later complemented by an MRI. Having no current symptoms, I had completely overlooked this incident from my high school years until I accidentally discovered these documents. Unfortunately, I don’t possess any images, but I have included pertinent information derived from the MRI report provided by my doctor. **COMPARATIVE ANALYSIS:** CT scan of the head **METHODOLOGY:** A standard MRI of the brain was performed, which included various sequences such as sagittal T1, axial T2, FLAIR, and images weighted for diffusion. Intravenous MultiHance was administered at a volume of 19 cc. **RESULTS:** The MRI findings reveal a fat-signal intensity structure located along the left tentorium cerebelli, consistent with observations made in the previous CT scan. This structure shows fat signal intensity across all imaging sequences and does not exert significant mass effect on the adjacent left cerebellar hemisphere. It is positioned along the underside of the tentorium, in proximity to the left posterior-lateral side of the quadrigeminal cistern, with normal appearance in the immediate adjacent colliculi. No areas of restricted diffusion were noted, nor were there signs of recent infarction or intracranial bleeding. There were no unusual fluid accumulations, hydrocephalus, or midline shifts. The cervical medullary junction appears normal, the corpus callosum is intact, and the paranasal sinuses show no air-fluid levels. **DIAGNOSIS:** A hyperintense structure on T1-weighted images is traced along the undersurface of the left tentorium cerebelli. This is consistent with fat signal intensity across all images and does not present significant mass effects, suggesting it is likely an intracranial lipoma. However, the potential for a ruptured dermoid is also noted. No restricted diffusion was seen to indicate an epidermoid lesion. Overall, this appearance is unchanged when compared with the earlier CT scan, and there’s no indication of recent infarction, intracranial hemorrhage, or any mass lesions. Though I currently experience no symptoms, I am contemplating whether this mass in my brain warrants further evaluation, as it appears there has been no follow-up after the MRI.

Answers (1)

7/11/2025, 2:31:03 PM

OpenHealth AI

It's understandable to feel concerned after discovering past imaging results, especially something as significant as a potential intracranial mass. Based on the details you provided, the MRI findings suggest that the structure is likely an intracranial lipoma, which is generally a benign lesion and not associated with symptoms or complications. Below, I'll outline the key points and actionable steps for you.

Main Points:

1. Current Findings: Your MRI indicates a hyperintense structure likely consistent with an intracranial lipoma, which appears stable and does not show signs of complications.
2. Symptom Status: You have reported no current symptoms or issues relating to this finding.
3. Follow-Up Consideration: Given that there has been no follow-up treatment or evaluation since the MRI, you may be considering if further review is necessary.

Explanation:

Intracranial lipomas are rare and usually harmless malformations of fat tissue in the brain. The stability of your findings over time is reassuring, as they indicate that it's unlikely to be problematic. The absence of symptoms such as headaches, neurological deficits, or seizures further supports that no immediate action is needed. A ruptured dermoid cyst can pose more risks, but the lack of restricted diffusion on the MRI suggests this possibility is unlikely.

Next Steps:

1. Monitor Your Health: Continue to be attentive to any new neurological symptoms (e.g., persistent headaches, vision changes, etc.). If you notice any of these, it would be important to seek medical attention.
2. Consider a Follow-Up Consultation: Although you currently have no symptoms, consider reaching out to a neurologist or your primary care physician to discuss the need for a follow-up imaging study or evaluation. They can provide a tailored recommendation based on your specific history and the previous reports.
3. Keep Records: Maintain a copy of your imaging reports and any future evaluations or assessments. This can be helpful for ongoing health management.

If you have any further questions or need emotional support during this time, don't hesitate to ask. It’s completely normal to feel unsettled by these findings, but taking proactive steps can help you feel more in control.