Herniation of the Flocculus Cerebellaris into the Internal Auditory Canal: A Rare Anatomical Variant Mimicking a Vestibular Pathology

We report a rare case of herniation of the flocculus cerebellaris into the internal auditory canal (IAC) and discuss the radiologic features and clinical implications in light of the current literature. A 19-year-old male with vestibular symptoms underwent high-resolution magnetic resonance imaging (MRI), which revealed cerebellar tissue within the right IAC. Multiplanar MRI sequences showed extension of the flocculus into the IAC with no evidence of mass effect or neurovascular compression. Herniation of the flocculus cerebellaris into the IAC is a rare anatomic variant that can mimic neoplastic lesions. Awareness of this entity is critical to avoid misdiagnosis and unnecessary intervention. This case report highlights the importance of a rare anatomical variant in the differential diagnosis.