 There is herniation of the anterior right medial orbitofrontal gyrus through a bony defect in the right fovea ethmoidalis, measuring up to approximately 15 mm. There is a small amount of cerebrospinal fluid along with the herniated brain. There is deformity of the right gyrus rectus. There is no midline shift. There is no evidence of acute infarction or intracranial abscess. There is an enlarged partially empty sella. There are postoperative findings related to functional endoscopic surgery, including bilateral uncinectomy and ethmoidectomy. There is diffuse mucosal thickening is present in the remaining ethmoid air cells, maxillary sinuses and frontal sinuses. There is also diffuse mild mucosal enlargement of the bilateral nasal turbinates. There is fluid in the nasal cavity and nasopharynx likely attributable to intubation. The orbits are unremarkable.
1. Findings compatible with a small ethmoidal meningoencephalocele.2. Postoperative findings related to endoscopic sinus surgery with diffuse paranasal sinus mucosal thickening and diffuse turbinate hypertrophy.3. Enlarged and partially empty sella, which may be associated with pseudotumor cerebri.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.