Clinical question: Incidental finding on head CT. Sclerotic changes of right parietal calvarium, MRI follow up for further evaluation was commented. Signs and symptoms: Patient is a status post fall on ice, hit head on the left side. Incidental finding of a sclerotic bony changes head CT. Pre-and post brain MRI:No acute intracranial process.Examination demonstrates a irregular focus of T1, T2 and T2 flair hypointensity without enhancement arising from the inner table of the right parietal bone corresponding to region of sclerotic bony change on head CT. This finding measures approximately at 19 x 21 mm in transaxial dimensions.Findings results in very subtle flattening deformity of the descending cerebral cortex however is without causing edema or abnormal enhancement.Findings to represent a calvarial osteoma. Possibility of a totally calcified/burned out meningioma cannot be entirely excluded.Examination otherwise demonstrate normal anatomical morphology and signal intensity brain parenchyma on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and myelination of brain.No detectable abnormal parenchymal, leptomeningeal enhancement. No evidence of calvarial or soft tissues of the scalp enhancement.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal sacrum intensity.
1.A benign calvarial osteoma in the right parietal region as detailed. The less likely totally calcified/burned out meningioma cannot be entirely excluded.2.Unremarkable pre-and post enhanced brain MRI otherwise. 