{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:53:41Z","timestamp":1782867221268,"version":"3.54.5"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"26","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Dermoid cysts are congenital lesions that typically occur along the midline. They usually remain asymptomatic unless ruptured, causing meningitis, hydrocephalus, or cranial nerve deficits. This case presents an exceptionally rare scenario of bilateral, symmetric intradiploic dermoid cysts of the occipital bone, which initially manifested as sensorineural hearing loss (an unusual symptom).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 21-year-old woman presented with right-sided hearing loss. Imaging showed bilateral, symmetric intradiploic cystic lesions within the occipital bone. The right-sided lesion had ruptured into the posterior fossa, releasing lipid-rich contents over the cerebellum. A T1-hyperintense signal along the right vestibular aqueduct suggested the migration of debris into the inner ear. Both lesions were resected with maximal safe resection, targeting the ruptured component and preventing future complications. Histopathological analysis confirmed that both lesions were dermoid cysts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Although typically associated with chemical meningitis, dermoid cyst rupture may rarely present solely with sensorineural hearing loss when fatty debris migrates into the vestibular aqueduct. Bilateral, symmetric intradiploic occipital lesions are rare and may reflect developmental anomalies at paired ossification centers. Surgical removal of the antigenic source, even without acute complications, may prevent delayed sequelae. A tailored resection approach that preserves vital structures, including the transverse sinus, is safe and effective.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE2691\">https:\/\/thejns.org\/doi\/10.3171\/CASE2691<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case2691","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:10:35Z","timestamp":1782864635000},"source":"Crossref","is-referenced-by-count":0,"title":["Bilateral intradiploic dermoid cysts with unilateral rupture causing hearing loss: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Saaya","family":"Maruyama","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoyuki","family":"Yanaka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minami","family":"Saura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2144-663X","authenticated-orcid":true,"given":"Toshihide","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Aiyama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tsukuba Memorial Hospital, Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriaki","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Institute of Medicine, University of Tsukuba, Ibaraki"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7172-7608","authenticated-orcid":true,"given":"Aiki","family":"Marushima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"148","article-title":"Epidermoid and dermoid sequestration cysts","volume":"110","author":"Pear","year":"1970","unstructured":"Pear BL.Epidermoid and dermoid sequestration cysts. Am J Roentgenol Radium Ther Nucl Med. 1970;110(1):148-155. doi:10.2214\/AJR.110.1.148"},{"issue":"6","key":"bib2","series-title":"Radiographics","first-page":"1437","article-title":"Teratomas, dermoids, and epidermoids of the head and neck","volume":"15","author":"Smirniotopoulos","year":"1995","unstructured":"Smirniotopoulos JGChiechi MV.Teratomas, dermoids, and epidermoids of the head and neck. Radiographics. 1995;15(6):1437-1455. doi:10.1148\/radiographics.15.6.8577967"},{"issue":"3","key":"bib3","series-title":"Br J Neurosurg","first-page":"414","article-title":"Intradiploic dermoid cyst: a rare cause of intracranial hypertension","volume":"28","author":"Hashemi","year":"2014","unstructured":"Hashemi SMRHedayat MRAlghasi M.Intradiploic dermoid cyst: a rare cause of intracranial hypertension. Br J Neurosurg. 2014;28(3):414-415. doi:10.3109\/02688697.2013.841846"},{"key":"bib4","series-title":"Surg Neurol Int","first-page":"282","article-title":"Infratentorial abscess secondary to dermal sinus associated with dermoid cyst in children: review of the literature and report of a rare case","volume":"12","author":"Colamaria","year":"2021","unstructured":"Colamaria ABlagia MSacco MIodice SCarbone F.Infratentorial abscess secondary to dermal sinus associated with dermoid cyst in children: review of the literature and report of a rare case. Surg Neurol Int. 2021;12:282. doi:10.25259\/sni_344_2021"},{"issue":"12","key":"bib5","series-title":"Acta Neurochir (Wien)","first-page":"1227","article-title":"Intracranial dermoid cysts: variations of radiological and clinical features","volume":"150","author":"Orakcioglu","year":"2008","unstructured":"Orakcioglu BHalatsch MEFortunati MUnterberg AYonekawa Y.Intracranial dermoid cysts: variations of radiological and clinical features. Acta Neurochir (Wien). 2008;150(12):1227-1234. doi:10.1007\/s00701-008-0152-x"},{"issue":"5","key":"bib6","series-title":"AJNR, Am J Neuroradiol","first-page":"E69","article-title":"Intracranial dermoid cyst ruptured into the membranous labyrinth causing sudden sensorineural hearing loss: CT and MR imaging findings","volume":"33","author":"Koh","year":"2012","unstructured":"Koh YCChoi JWMoon WJRoh HGPark HJ.Intracranial dermoid cyst ruptured into the membranous labyrinth causing sudden sensorineural hearing loss: CT and MR imaging findings. AJNR, Am J Neuroradiol. 2012;33(5):E69-E71. doi:10.3174\/ajnr.a2627"},{"issue":"6","key":"bib7","series-title":"J Korean Soc Radiol","first-page":"1194","article-title":"Intracranial rupture of an intradiploic dermoid cyst resembling an erupting volcano: a case report","volume":"85","author":"Ankush","year":"2024","unstructured":"Ankush ASardessai SGupta VBurman S.Intracranial rupture of an intradiploic dermoid cyst resembling an erupting volcano: a case report. J Korean Soc Radiol. 2024;85(6):1194-1199. doi:10.3348\/jksr.2023.0162"},{"issue":"3","key":"bib8","series-title":"Neurol Neurochir Pol","first-page":"308","article-title":"Ruptured intradiploic dermoid cyst overlying the torcular herophili","volume":"44","author":"Gulsen","year":"2010","unstructured":"Gulsen SYilmaz CSerhat CAltinors N.Ruptured intradiploic dermoid cyst overlying the torcular herophili. Neurol Neurochir Pol. 2010;44(3):308-313. doi:10.1016\/s0028-3843(14)60047-5"},{"issue":"3","key":"bib9","series-title":"Radiology","first-page":"747","article-title":"Suture closure in the human chondrocranium: CT assessment","volume":"196","author":"Madeline","year":"1995","unstructured":"Madeline LAElster AD.Suture closure in the human chondrocranium: CT assessment. Radiology. 1995;196(3):747-756. doi:10.1148\/radiology.196.3.7644639"},{"issue":"2","key":"bib10","series-title":"Neurosurgery","first-page":"377","article-title":"Ruptured intracranial dermoid cysts: clinical, radiographic, and surgical features","volume":"62","author":"Liu","year":"2008","unstructured":"Liu JKGottfried ONSalzman KLSchmidt RHCouldwell WT.Ruptured intracranial dermoid cysts: clinical, radiographic, and surgical features. 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Radiographics. 1995;15(6):1437-1455. doi:10.1148\/radiographics.15.6.8577967"},{"issue":"3","key":"bib3","series-title":"Br J Neurosurg","first-page":"414","article-title":"Intradiploic dermoid cyst: a rare cause of intracranial hypertension","volume":"28","author":"Hashemi","year":"2014","unstructured":"Hashemi SMRHedayat MRAlghasi M.Intradiploic dermoid cyst: a rare cause of intracranial hypertension. Br J Neurosurg. 2014;28(3):414-415. doi:10.3109\/02688697.2013.841846"},{"key":"bib4","series-title":"Surg Neurol Int","first-page":"282","article-title":"Infratentorial abscess secondary to dermal sinus associated with dermoid cyst in children: review of the literature and report of a rare case","volume":"12","author":"Colamaria","year":"2021","unstructured":"Colamaria ABlagia MSacco MIodice SCarbone F.Infratentorial abscess secondary to dermal sinus associated with dermoid cyst in children: review of the literature and report of a rare case. Surg Neurol Int. 2021;12:282. doi:10.25259\/sni_344_2021"},{"issue":"12","key":"bib5","series-title":"Acta Neurochir (Wien)","first-page":"1227","article-title":"Intracranial dermoid cysts: variations of radiological and clinical features","volume":"150","author":"Orakcioglu","year":"2008","unstructured":"Orakcioglu BHalatsch MEFortunati MUnterberg AYonekawa Y.Intracranial dermoid cysts: variations of radiological and clinical features. Acta Neurochir (Wien). 2008;150(12):1227-1234. doi:10.1007\/s00701-008-0152-x"},{"issue":"5","key":"bib6","series-title":"AJNR, Am J Neuroradiol","first-page":"E69","article-title":"Intracranial dermoid cyst ruptured into the membranous labyrinth causing sudden sensorineural hearing loss: CT and MR imaging findings","volume":"33","author":"Koh","year":"2012","unstructured":"Koh YCChoi JWMoon WJRoh HGPark HJ.Intracranial dermoid cyst ruptured into the membranous labyrinth causing sudden sensorineural hearing loss: CT and MR imaging findings. AJNR, Am J Neuroradiol. 2012;33(5):E69-E71. doi:10.3174\/ajnr.a2627"},{"issue":"6","key":"bib7","series-title":"J Korean Soc Radiol","first-page":"1194","article-title":"Intracranial rupture of an intradiploic dermoid cyst resembling an erupting volcano: a case report","volume":"85","author":"Ankush","year":"2024","unstructured":"Ankush ASardessai SGupta VBurman S.Intracranial rupture of an intradiploic dermoid cyst resembling an erupting volcano: a case report. J Korean Soc Radiol. 2024;85(6):1194-1199. doi:10.3348\/jksr.2023.0162"},{"issue":"3","key":"bib8","series-title":"Neurol Neurochir Pol","first-page":"308","article-title":"Ruptured intradiploic dermoid cyst overlying the torcular herophili","volume":"44","author":"Gulsen","year":"2010","unstructured":"Gulsen SYilmaz CSerhat CAltinors N.Ruptured intradiploic dermoid cyst overlying the torcular herophili. Neurol Neurochir Pol. 2010;44(3):308-313. doi:10.1016\/s0028-3843(14)60047-5"},{"issue":"3","key":"bib9","series-title":"Radiology","first-page":"747","article-title":"Suture closure in the human chondrocranium: CT assessment","volume":"196","author":"Madeline","year":"1995","unstructured":"Madeline LAElster AD.Suture closure in the human chondrocranium: CT assessment. Radiology. 1995;196(3):747-756. doi:10.1148\/radiology.196.3.7644639"},{"issue":"2","key":"bib10","series-title":"Neurosurgery","first-page":"377","article-title":"Ruptured intracranial dermoid cysts: clinical, radiographic, and surgical features","volume":"62","author":"Liu","year":"2008","unstructured":"Liu JKGottfried ONSalzman KLSchmidt RHCouldwell WT.Ruptured intracranial dermoid cysts: clinical, radiographic, and surgical features. 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