If your baby's encephalocele is at the back of the head, it is called an occipital encephalocele. This is the most common type in the Western Hemisphere — roughly three-quarters of cases.
What it looks like
An occipital encephalocele appears as a sac at the back of the skull, in or near the midline. Sacs vary enormously in size — from small to very large — and, importantly, the size of the sac does not reliably tell you what's inside.
Why the back of the head matters
Location matters for outlook, and occipital (posterior) encephaloceles deserve careful, honest discussion. Compared with anterior (front) or parietal (top) encephaloceles, occipital ones are more likely to contain significant brain tissue and to be associated with hydrocephalus. Studies generally find that occipital location carries a more guarded outlook than parietal or anterior location, especially when a large amount of brain tissue is in the sac.
This is not a reason to lose hope — many children with occipital encephaloceles, particularly smaller ones with little brain involvement, do well. It is a reason to get detailed imaging and an experienced team.
What drives the outlook
For occipital encephalocele, the outlook depends most on:
- How much brain tissue is in the sac (more tissue = more guarded outlook)
- Whether hydrocephalus is present
- How the rest of the brain has formed
- The presence of other anomalies or a syndrome
- The size of the bony defect
Treatment overview
Treatment is surgical: the team repairs the bony and membrane (dural) defects, returns or removes tissue as appropriate, and closes the opening in a watertight way. If hydrocephalus is present or develops, a shunt may be needed. (A dedicated surgery article covers this in more detail.)
Sources
- StatPearls (NCBI Bookshelf) — Encephalocele
- Cleveland Clinic — Encephalocele
- Child's Nervous System / peer-reviewed literature — posterior vault encephaloceles outcomes
- CHOP — Encephalocele