Wax Droplets Lining Ventricles.

Rupture of the spinal dermoid is rare. There may be intracranial deposition of fat secondary to it. We report a case of an adult male who presented with features of obstructive hydrocephalus secondary to ruptured lumbar dermoid. A 42-year-male presented with acute-onset headache and vomiting for 2 days. There was grade 3 papilledema on fundus examination. Magnetic resonance imaging showed ventriculomegaly with aqueductal obstruction. Multiple T1 and T2 hyperintense deposits were also noted along the ventricular wall. Magnetic resonance imaging of the spine showed a T1, T2 hyperintense intramedullary lesion at the lumbar region with multiple fat deposits along the spinal axis. He underwent endoscopic third ventriculostomy and is doing well at the 6-month follow-up. He is asymptomatic for the spinal lesion. Silent rupture of the spinal dermoid causing obstructive hydrocephalus is rare. These patients may remain asymptomatic for the spinal lesion and improves with cerebrospinal fluid diversion.