Demographics:
19 years old, Male
Indication:
Sinusitis, headache
Findings
- Thin, mildly T2 hyperintense subdural collection overlying the anterior right frontal lobe with associated restricted diffusion, measuring 2 mm in thickness
- Dural thickening and enhancement along the majority of the right frontal and temporal convexities
- No abnormal brain parenchymal signal to suggest cerebritis or abscess
- No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus
- Thin, peripherally enhancing subperiosteal collection with associated restricted diffusion along the outer table of the frontal bone on the right just superior to the right frontal sinus with extensive surrounding edema and soft tissue enhancement extending inferiorly into the right greater than left periorbital soft tissues
- Extensive mucosal thickening and opacification of the right frontal, right ethmoid, and right maxillary sinuses with associated internal restricted diffusion
Diagnosis
Complicated frontal sinusitis with subdural empyema
Sample Report
Acute right anterior drainage pathway sinusitis complicated by a thin right frontal convexity subdural empyema with surrounding pachymeningitis, a thin right frontal subperiosteal abscess, and right greater than left frontal scalp and periorbital cellulitis.
No evidence of cerebritis or brain abscess.
Discussion