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Headache Medicine, v.10, n.4, p.203-204, Out/Nov/Dez. 2019
ABSTRACT
RESUMO
Descritores: Migrânea; Epilepsia; Lipoma intracraniano.
CASE REPORT
Intracranial lipoma manifesting with change in preexisting
headache characteristics
Lipoma intracraniano que se manifesta com mudança das
características de cefaleia preexistente
Patrick Emanuell Mesquita Sousa Santos
1
Ivan Rodrigues Silva
1,2
Mário Fernando Prieto Peres
3
Raimundo Pereira Silva-Néto
1
1
Federal University of Delta of Parnaíba, Brazil.
2
Dirceu Arcoverde State Hospital, Parnaíba,
Brazil.
3
Education and Research Israelite Institute
Albert Einstein, Brazil; Institute of Psychiatry,
HCFMUSP, Brazil.
*Correspondence
R. P. Silva-Néto
Federal University of Delta of Parnaíba,
Avenida São Sebastião, 2819, Fátima,
Parnaíba, PI 64001-020, Brazil. E-mail:
neurocefaleia@terra.com.br
Received: December 15, 2019.
Accepted: December 22, 2019.
Intracranial lipomas represent 0.1% to 0.5% of all intracranial tumors.
Approximately half of the patients are asymptomatic. In symptomatic patients,
headache is the most common symptom. We describe the case of a 71-year-old
woman with history of generalized seizures and episodic migraine for about
30 years. In recent months, there has been a change in the characteristics of
headache. She was admitted to the emergency room with muscle weakness
in left hemibody and intense headache onset approximately four hours ago.
Neuroimaging exams revealed a median frontal expansive lesion suggestive of
intracranial lipoma.
Keywords: Migraine; Epilepsy; Intracranial lipoma.
Lipomas intracranianos representam 0,1% a 0,5% de todos os tumores
intracranianos. Cerca de metade dos pacientes portadores dessa rara formação
são assintomáticos. Naqueles sintomáticos, a cefaleia é o principal sintoma. Nós
descrevemos o caso de uma mulher de 71 anos com história de convulsões e
migrânea episódica há cerca de 30 anos. Nos últimos meses, houve mudanças
nas características da dor. Ela foi admitida na emergência com fraqueza
muscular no hemicorpo esquerdo e intensa cefaleia, com início há cerca de
quatro horas. Os exames de imagem revelaram uma lesão expansiva frontal
mediana sugestiva de lipoma intracraniano.
Intracranial lipoma
Santos PEMS, et al.
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Headache Medicine, v.10, n.4, p.203-204, Out/Nov/Dez. 2019
We describe the case of a 71-year-old woman with
history of generalized seizures and episodic migraine
for about 30 years. Headache presented pressure
characteristics, worsening in the last two months. Before,
she had three headache attacks a week, but in recent
months, headache occurs daily. Headache attacks don’t
remit with simple analgesics. Recently, she was admitted
to the emergency room with muscle weakness in left
hemibody and intense headache onset approximately
four hours ago. Her neurologic examination was normal.
Diagnostic hypothesis of stroke was considered.
She underwent a CT scan of the skull that showed an
interhemispheric hypodense mass. MRI revealed a
median frontal expansive lesion suggestive of intracranial
lipoma (Figure 1).
Intracranial lipomas (IL) represent 0.1% to 0.5% of all
intracranial tumors and are located mainly in the area of
corpus callosum
1
. A retrospective study with 17 patients
diagnosed with IL was conducted at a tertiary center.
He showed that 47% of these patients complained of
headache
2
. There is another study stating that half of the
cases of IL was asymptomatic. In the other half, the main
symptoms were seizures, headache and muscle weakness
3
.
Surgical intervention is rarely required, because
there may be vascular structures near or within the
lipomas and complications may develop due to surgical
excision
2
. Thus, the best therapeutic option for IL
symptoms remains unclear.
REFERENCES
1. Ben Elhend S, Belfquih H, Hammoune N, Athmane EM,
Mouhsine A (2019) Lipoma withagenesis of corpus
callosum: 2 case reports and literature review. World
Neurosurg, 125:123–125.
2. Seidl Z, Vaneckova M, Vitak T (2007), Intracranial lipomas:
A retrospective study. Neuroradiol J, 20(1):30–36.
3. Piovesan EJ, Tatsui CE, Kowacs PA, Prazeres RF, Lange
MC, Antoniuk SA, et al (2000), Lipoma do corpo caloso
associado a hipertroa do corpo caloso: Relato de caso.
Arq Neuropsiquiatr, 58(3B):947–951.
Figure 1. (A) CT. (B) Axial RNM T1W. (C) Coronal RNM T2W. (D) Axial RNM T2W. (E) Sagittal RNM T1W.Frontal median lesion of fat
content measuring about 6.6 x 4.5 x 3.5 cm associated with signs of corpus callosum dysgenesis and colpocephalic aspect of the
lateral ventricles.
