Objective and importance: We report the case of a woman presenting with sudden neurological deficit, revealing a parasellar dermoid cyst. To our knowledge, this clinicopathological finding is the first reported in the literature.
Clinical presentation: A neurological examination of the patient revealed a left hemiparesis, including central facial palsy, which hampered her speech. The well-documented neuroradiological work-up (including computed tomography, magnetic resonance imaging, and magnetic resonance angiography) demonstrated right frontorolandic ischemia caused by a right supra- and parasellar dermoid cyst leading to middle and anterior cerebral arterial stenoses.
Intervention: Surgical intervention, using a right subfrontopterional approach, was successful. Complete dermoid cyst removal was achieved. The mechanism of the arterial stenoses is extensively discussed and is thought to result from an inflammatory reaction of the basal vessels.
Conclusion: The patient recovered fully. Nevertheless, postoperative magnetic resonance imaging confirmed cerebral infarction.