 There is a focal 9-mm defect along the right ethmoid sinus roof with apparent herniation of a small focal portion of the inferior right frontal lobe cortex, suspicious for small encephalocele. This is best visualized on series 12 image 9, series 10 image 1 and series 13 image 47.There is no hippocampal signal abnormality or volume loss. There is no evidence of gray matter heterotopia or cortical dysplasia. There is no suspicious intracranial enhancement, acute infarct, mass effect, midline shift or herniation. There is minimal nonspecific periventricular and subcortical white matter is T2 signal abnormality likely representing chronic microvascular ischemic changes. There is moderate left maxillary, severe left ethmoid sinus mucosal thickening. There is a moderate left sphenoid sinus air-fluid level.
1.Finding suspicious for small encephalocele herniating through a defect in the right ethmoid roof. This can be further evaluated with skull base MRI/CT as clinically indicated. Please see details above.2.No other evidence of seizure foci or intracranial mass.