Clinical question: New daily headaches. Signs and symptoms: As above. Pre-and post-enhanced brain MRI:Negative diffusion weighted images.There is normal anatomical morphology and signal intensity of brain parenchyma on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.No detectable abnormal parenchymal, leptomeningeal or calvarial enhancement. Unremarkable images through the orbits and including axial fat sat post enhanced series.There is complete opacification of the larger right chamber sphenoid sinus with intense mucosal enhancement and consistent with chronic sinus disease. Mild bilateral maxillary sinus mucosal thickening consistent with chronic sinusitis is also present. Bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal patterns.
1.Unremarkable pre-and post enhanced brain MRI.2.Complete opacification of larger right chamber of sphenoid and bilateral maxillary mucosal thickening consistent with chronic sinusitis.