2 years, Male, strep pneumonia meningitis. Previous seen areas of nonsuppression of CSF in the cerebral hemispheres on the FLAIR sequences have resolved. Subtle foci of T2/FLAIR hyperintensity are again seen within the bilateral cerebellar hemispheres, which are slightly decreased in prominence on the right and slightly increased on the left. There is subtle associated diffusion hyperintensity. No abnormal parenchymal or meningeal enhancement is appreciated. No intracranial mass or mass effect. No findings to suggest cerebral abscess or evidence of empyema. Ventricles are normal in size without evidence of hydrocephalus. No evidence of acute ischemia or hemorrhage.There is symmetric enhancement of the bilateral cavernous sinuses without evidence of cavernous sinus thrombosis. Pituitary gland appears unremarkable for patient's age. Bilateral orbits appear grossly unremarkable. Interval marked improvement in previously seen opacification of the bilateral maxillary sinuses and ethmoid sinuses is noted. Previously seen opacification of the left mastoid air cells is much improved with mild residual opacification.
1. No evidence of cavernous sinus thrombosis. No evidence of intraparenchymal abscess or empyema. 2. Previously seen nonsuppression of CSF on the FLAIR sequence related to meningitis is no longer appreciated and is suggestive of overall improvement of meningitis. There are however subtle foci of FLAIR hyperintensity in the bilateral cerebellar hemispheres, which are slightly decreased on the right and slightly increased on the left since 1/1/2016; these findings are likely related to parenchymal involvement of infection.3. Interval improvement in previously seen paranasal sinus opacification as well as improved aeration of the left mastoid air cells.