Summary
The authors analysed the contents of two intracranial epidermoids showing low density on computerized tomography. Although both cases had approximately similar composition, 85, 83% for water, 12,12.5% for protein, 3,4.5% for total lipid including cholesterol, respectively, the absorption values differed from each other. Both tumours were identified to communicate with CSF, one by delayed metrizamide CT scan and the other by direct aspiration during operation. The low absorption values in both cases resembled or were slightly higher than that of CSF in each case, and not a single pixel showed negative values for lipid. These findings suggest that it is the CSF content within the anatomical interstices or structural crevice of the tumour, rather than cholesterol, which is responsible for the low absorption values which appeared in the CT scan.
Similar content being viewed by others
References
Braun, I. F., Naidich, T. P., Leeds, N. E., Koslow, M., Zimmerman, H. M., Chase, N. E., Dense intracranial epidermoid tumors. Radiology122 (1977), 717–719.
Chambers, A. A., Lukin, R. R., Tomisck, T. A., Cranial epidermoid tumors: Diagnosis by computed tomography. Neurosurgery1 (1977), 276–280.
Cornell, S. H., Graf, C. J., Dolan, K. D., Fat-fluid level in intracranial epidermoid cyst. Am. J. Roentgenol.128 (1977), 502–503.
Davis, K. R., Roberson, G. H., Taveras, J. M., New, P. F., Trevor, R., Diagnosis of epidermoid tumor by computed tomography. Radiology119 (1976), 347–353
Dee, R. H., Kishore, P. R. S., Young, H. F., Radiological evaluation of cerebellopontine angle epidermoid tumors. Surg. Neurol.13 (1980), 293–296.
Fawcitt, R. A., Isherwood, I., Radiodiagnosis of intracranial pearly tumors with particular reference to the value of computer tomography. Neuroradiology11 (1976), 235–242.
Folch, J., Lees, M., Sloane-Stanley, G. H., A simple method for the isolation and purification of total lipids from animal tissues. J. Biol. Chem.226 (1957), 497–509.
Fruin, A. H., Mickle, J. P., Epidermoid tumors-diagnotic dilemmas. Nebraska Med. J.65 (1980), 27–29.
Handa, J., Okamoto, K., Nakasu, Y., Nakasu, S., Nakano, Y., Computed tomography of intracranial epidermoid tumors with special reference to atypical features. Acta Neurochir. (Wien)58 (1981), 221–228.
Hasegawa, H., Bitoh, S., Nakata, M., Fujiwara, M., Yasuda, H., Intracranial epidermoids mimicking meningioma. Surg. Neurol.15 (1981), 372–374.
Hiratsuka, H., Okada, K., Matsunaga, M., Tanaka, K., Fukai., N., Inaba, Y., Diagnosis of epidermoid cysts by metrizamide CT cisternography. Neuroradiology26 (1984), 153–155.
Imamura, Y., Ninchoji, T., Nakajima, S., Uemura, K., Epidermoid tumor in the fourth ventricle, with particular reference to mentrizamide CT cisternography findings. Surg. Neurol.18 (1982), 444–447.
Mikhael, M. A., Mattar, A. G., Intracranial pearly tumors: The role of computed tomography, angiography and pneumoencephalography. J. Comput. Assist. Tomogr.2 (1978), 421–429.
Laster, D. W., Moody, D. M., Marshall, R. B., Epidermoid tumors with intraventricular and subarachnoid fat: report of two cases. Am. J. Roentgenol.128 (1977), 504–507.
Lowry, O. H., Rosebrough, N. J., Farr, A. L., Randall, R. J., Protein measurement with the folin phenol reagent. J. Biol. Chem.193 (1971), 265–275.
Nagashima, C., Takahama, M., Sakaguchi, A., Dense cerebellopontine epidermoid cyst. Surg. Neurol.17 (1982), 172–177.
Naidich, T. P., Lin, J. P., Leeds, N. E., Kircheff, I. I., George, A. E., Chase, N. E., Pudlowski, R. M., Passalaqua, A., Computed tomography in diagnosis of extra-axial posterior fossa masses. Radiology120 (1976), 333–339.
New, P. F. J., Arnow, S., Attenuation measurements of whole blood and blood fractions in computed tomography. Radiology121 (1976), 635–640.
Rosario, M., Becker, D. M., Conley, F. K., Epidermoid tumors involving the fourth ventricle. Neurosurg.9 (1981), 9–13.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hwang, W.Z., Hasegawa, T., Ito, H. et al. Intracranial epidermoids—Concerning the low absorption value on computerized tomography. Acta neurochir 78, 33–37 (1985). https://doi.org/10.1007/BF01809238
Issue Date:
DOI: https://doi.org/10.1007/BF01809238