60 years, Male, multiple myeloma. Numbness in face, V3 There is smooth thickening and enhancement of the dura along the bilateral cerebral convexities with suggestion of associated small bilateral subdural effusions. No associated intracranial mass effect. Brain parenchyma appears otherwise within normal limits. No abnormal parenchymal or meningeal enhancement to suggest metastatic disease. No evidence of acute infarct or hemorrhage. Ventricles are normal in size without evidence of hydrocephalus. There is mild nonspecific opacification of the bilateral mastoid air cells. Bone marrow signal is heterogeneous which is nonspecific. No destructive calvarial lesions.
1. No intracranial mass or abnormal enhancement to suggest neoplastic disease. Specifically no lesions along the intracranial course of the trigeminal nerves. No destructive lesions within the calvarium to suggest myeloma. 2. Diffuse dural enhancement with suggestion of small bilateral subdural effusions. No associated mass effect. Finding is nonspecific with a broad differential including prior lumbar puncture, associated with intracranial hypotension, reactive to tiny subdural effusions, or represent a mild inflammatory pachymeningitis for example. 