Intracranial lipomas are infiltrative tumours and tend to insinuate between or around vessels and nerves, opposed to dermoids which are encapsulated tumours displacing these structures. In symptomatic patients, associated cortical dysplasia or other anomalies need to be ruled out.

From the manuscript

A symptomatic Sylvian fissure lipoma in a post-traumatic patient

Abstract
Lipomatous extra-axial lesions in the Sylvian fissure are a rare entity. Their identification, however, is usually simple if a systematic radiological approach is adopted. The best line of management for these lesions is still a matter of controversy and fraught with complications. We present a case of a Sylvian fissure lipoma referred to our neurosurgery services with symptomatic seizures and in a post-traumatic patient. The radiological differentiating features of intracranial lipomas and intracranial dermoids have been discussed. The unusual location of the lesion, in combination with the history of seizures and the nature of presentation (trauma being a red-herring) make this case an interesting find. The lesion was managed conservatively with good outcomes at follow up, on anti-epileptic medications.