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Last Updated: October 1, 2018

Figure 1: Adult Encephalocele. Coronal (top row left) and sagittal (top row right) CT images through the nasal cavity demonstrates a defect in the left cribriform plate and a portion of the fovea ethmoidalis. The left ethmoid sinuses and left nasal cavity are occluded by fluid or soft tissue. The dark signal on axial FLAIR (middle row left) and bright signal on coronal T2 (middle row right and bottom row left) images indicates that the abnormality is primarily made up of fluid, but the T2 images show small amounts of intermediate signal soft tissue that represents herniated/ectopic brain parenchyma. The connection between the encephalocele and the left frontal lobe can be seen on coronal T2 (middle row right). As expected, there is little to no enhancement in this lesion on T1 +C (bottom row right). The occlusion of the left maxillary sinus (top row left, middle row left, middle row right, bottom row left) and left frontal sinus (top row right, bottom row left) are secondary to obstruction by the encephalocele.

Figure 2: Child Occipital Encephalocele. Encephaloceles may be quite large, but the parenchyma within the encephalocele should be similar in its signal intensity to normal brain parenchyma as demonstrated on axial FLAIR (top row left) and T1 (top row right – axial, bottom row – sagittal). The size of the calvarial defect, thickness of the encephalocele pedicle, and involved intracranial structures can be clearly seen on MRI. Variable amounts of CSF may be seen in the protruding defect. Very little CSF is present in this encephalocele.

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