Fever. Evaluate for intracranial or ophthalmologic process. History of papilledema and tortuous ocular vessels with 19 days of fever. MRI Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is minimal fluid within the right anterior ethmoid sinus.MRV: The superior sagittal sinus, inferior sagittal sinus, transverse sinuses, sigmoid sinuses, straight sinus, vein of Galen, internal cerebral veins, and several visualized cortical veins are patent. There is no evidence of venous thrombosis.MRI ORBITS: No abnormal mass or abnormal enhancement is seen. No abnormal signal intensity is evident. The optic nerves are normal in size but with mild flattening of bilateral posterior sclera, and even slight elevation of the right optic nerve head. There is no associated enhancement or focal diffusion abnormality. There is also slight nonspecific fluid distension of the distal optic nerve sheaths bilaterally. No retrobulbar mass, chiasmatic mass, or parasellar abnormality is seen. Extraocular muscles are unremarkable.
1.Unremarkable MRI of the brain.2.Slight flattening of the posterior sclera with subtle elevation of the right optic nerve head and slight fluid distension of distal optic nerve sheaths, compatible with history of papilledema. 3. Normal MRV.