New daily persistent headache (ndph) [G44.52], Reason for Study: ^Reason: 57M s/p OLT now with headaches and leukopenia. Donor with ?histoplasmosis. History: Headaches and leukopenia No evidence of acute ischemic or hemorrhagic lesion.There are subtle smooth dural enhancement on postcontrast enhancement T1 axial scan. However, there is no evidence of focal nodular enhancing lesion on the scan. This findings are non specific and differential diagnosis include meningitis or meningeal irritation or intracranial hypotension. If clinically indicated, diagnostic lumbar puncture can be considered.The ventricles, sulci and cisterns are symmetric and unremarkable.There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. No evidence of acute ischemic or hemorrhagic lesion.2. Smooth pachymeningeal enhancement, differential diagnosis include meningitis, meningeal irritation and intracranial hypotension.