Periorbital abscess with pneumocephalus. Signal artifact in the paranasal sinuses presumably related to recent endoscopic sinus surgery. The previously noted subperiosteal abscess involving the medial wall of the right orbit is no longer identified. There remains partial opacification of the ethmoid air cells, right greater than left, as well as within the right maxillary sinus however this is improved compared to prior. The previously noted epidural collection in the right anterior cranial fossa no longer contains appreciable fluid, however there is signal void related to continued pneumocephalus. There remains enhancement of the overlying dura but there has been resolution of the reactive edema in the right mesial orbital gyrus. No evidence of an intraparenchymal abscess. Remainder of the brain parenchyma is unremarkable. The ventricles and basal cisterns are normal in size and configuration. The expected intracranial vascular flow voids are present. The visualized mastoid air cells are clear.
1. Post surgical changes involving the medial wall of the orbit. No residual subperiosteal abscess is identified. 2. Residual focus of susceptibility artifact in the right anterior cranial fossa epidural space presumably related to pneumocephalus. No residual epidural fluid collection is identified. Interval improvement in the reactive edema in the overlying inferior orbital gyrus. No evidence of intraparenchymal abscess.3. Postsurgical changes involving the right paranasal sinuses which may be better evaluated on CT scan. There has been interval decrease in opacification of the right ethmoid and maxillary sinuses.