Asymptomatic rupture of an intracranial dermoid cyst: to intervene or not to intervene?

Dermoid cysts are an exceedingly rare phenomenon inside the cranial vault. These benign, slow-growing lesions can rupture, releasing cyst contents into the ventricular system and subarachnoid space causing pathology in the form of chemical meningitis and vasospasm. Here, we present the case of a 26-year-old man who was investigated for a facial nerve palsy and was incidentally found to have a ruptured dermoid cyst in the pineal region, with dissemination of cyst contents throughout the ventricular system.