A thirty year old female presented with sudden onset of severe headache, papilloedema and altered sensorium. Computerised tomography (CT) scan showed a hyperdense vermian mass in the posterior fossa. Operative findings and histological examination revealed spontaneous bleed into the epidermoid cyst. Difficulty in the preoperative diagnosis and uncommon presentation of the intracranial epidermoid cyst prompted us to report this case.
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