J Korean Soc Radiol.  2015 Jun;72(6):423-426. 10.3348/jksr.2015.72.6.423.

Intradiploic Encephalocele of the Left Parietal Bone: A Case Report

• Kim HS
• Huh CW
• Kim DS
• Mok JH
• Kim IS
• Yang GS

• KMID: 2098023
• DOI: http://doi.org/10.3348/jksr.2015.72.6.423

Abstract

Encephaloceles are generally regarded as midline abnormalities. A 50-year-old man presented with a parietal intradiploic encephalocele manifesting as intermittent headache for the past 6 months. Computed tomography (CT) showed bone destruction associated with a left parietal lesion. Magnetic resonance imaging (MRI) demonstrated brain herniation within the intradiploic space. Cerebral angiographic imaging showed a normal cerebral vessel pattern within the herniated brain lesion. In this case, surgical treatment may not be necessary in the absence of concurrent symptoms and neurologic deficit. We report the CT, MRI, and angiographic findings of an extremely rare case of parietal intradiploic encephalocele in adulthood.

MeSH Terms

Brain
Encephalocele*
Headache
Humans
Magnetic Resonance Imaging
Middle Aged
Neurologic Manifestations
Parietal Bone*
Rabeprazole

Figure

• 

  Fig. 1 Skull film: town view shows the left parietal defect (white arrow).

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  Fig. 2 Coronal image of bone window CT shows a defect of the inner table, widened diploic space (black arrow). There is marked thinning and erosion of the outer table of the left parietal parasagittal bone (white arrow).

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  Fig. 3 MRI shows a lesion in the parietal parasagittal intradiploic space continuous with the left parietal lobe appearing isointense with the normal brain on axial T2-weighted (A) image. Sagittal T2-weighted MRI shows a defect in the left parietal bone, which contains cerebrospinal fluid and herniated cerebral tissue (white arrow) (B).

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  Fig. 4 Left internal carotid artery angiogram with arterial (A) and venous (B) phase films show normal cerebral vessel pattern for herniated brain in left parietal bony defect area (black arrowheads).

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