Episode of acute loss of consciousness followed by generalized shaking and foaming through his mouth. The episode lasted for a minute and was followed by unresponsiveness and slow recovery. At ED patient complained of HA and nausea but otherwise neurological intact. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma, including the hippocampi, brainstem, and cerebellum appear unremarkable. There is no evidence of heterotopia or hamartoma. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration, including cavum septum pellucidum and vergae. There is no midline shift. The posterior fossa appears to be slightly small and the cerebellar tonsils appear to be mildly indented by the occipital bone, but are not particularly low lying. The major cerebral flow voids are intact. The orbits, mastoid air cells, and scalp soft tissues are grossly unremarkable. There are secretions in the right maxillary sinus.
1. No evidence of intracranial hemorrhage, mass, or acute infarct. 2. The posterior fossa appears to be slightly small and the cerebellar tonsils appear to be mildly indented by the occipital bone, but are not particularly low lying. This may represent a developmental variant, perhaps in the spectrum of a Chiari-type malformation.3. Findings suggestive of acute maxillary sinusitis.