Background: Intradiploic encephalocele (IE) is a rare condition with very few reported cases in the literature. IE is defined as a herniation of the brain parenchyma through a dural defect into the diploic space. Case Description: We present a 59-year-old man with intradiploic cerebellar encephalocele diagnosed in a background of clicks on the head when pressing over the ipsilateral occipital bone. Imaging confirmed right cerebellar brain herniation through the diploic space. Two years of follow-up imaging revealed herniation size progression with no neurology. The patient chose a watch-and-see approach given the potential morbidity of the surgical treatment. Conclusion: Asymptomatic or paucisymptomatic IE does not require surgical treatment. However, both clinicians and patients need to be aware of potential radiological progression during the follow-up period.
Elhag et al. (Fri,) studied this question.