Quadrigeminal Cistern Lipoma: A Case Report.

Intracranial lipomas are congenital malformations resulting from abnormal differentiation of the primitive meninx. They are most often discovered incidentally during neuroimaging performed for unrelated conditions. We report the case of an 11-year-old child who underwent brain magnetic resonance imaging (MRI) following head trauma without associated neurological symptoms. Imaging revealed a 1.3-cm right paramedian lipoma located within the quadrigeminal cistern, extending into the cerebral aqueduct without evidence of hydrocephalus. Given the absence of clinical manifestations, conservative management with radiological follow-up was adopted. Intracranial lipomas are typically slow-growing and asymptomatic lesions, most commonly found in the pericallosal cistern, followed by the quadrigeminal cistern. Although rare symptomatic cases may present with headaches, seizures, hydrocephalus, or visual disturbances requiring medical or surgical treatment, surgical intervention is generally avoided because of the intimate relationship of these lesions with critical neurovascular structures and their benign natural history. This case highlights the importance of recognizing intracranial lipomas as incidental findings and supports conservative management in asymptomatic patients, for whom the risks of surgery usually outweigh the potential benefits.