Altered mental status, multiple myeloma. The images are degraded by patient motion. There is a mass centred within the clivus with extension into the left cavernous sinus. There is no gross mass effect upon the pons. There is no evidence of intracranial hemorrhage or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The orbits and scalp soft tissues are grossly unremarkable. There is mild right maxillary and bilateral sphenoid sinus mucosal thickening and fluid in the left maxillary sinus.
1. A lesion in the central skull base with extension into the left cavernous sinus is likely related to multiple myeloma, but assessment of the previously demonstrated epidural extension is limited by patient motion and the lack of intravenous contrast.2. No evidence of acute intracranial hemorrhage or acute infarct.3. Findings suggestive of acute sinusitis.