Left mastoiditis, concern for brain involvement on CT MRI of the brainNo diffusion weighted abnormalities are appreciated.There is abnormal enhancement involving the left temporal bone where there is opacification of the left middle ear and mastoid air cells. There is a ring-enhancing lesion present at the expected location of the mastoid measuring approximately 19 x 12 mm coronal dimensions and another ring-enhancing lesion present within the right middle ear measuring 6 x 8 mm coronal dimensions. There is associated soft tissue swelling superficial to the left temporal bone and infiltration of the subcutaneous fat planes. There is enhancement along the left temporal bone including the squamous portion of the left temporal bone and the petrous portion. There is also extension along the left eustachian tube. The left external auditory canal is narrowed and displaced. There does not appear to be any involvement of the underlying brain. There is no subdural or epidural fluid collection appreciated.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. The visualized portions of the orbits are intact.MRV brain:The dural venous sinuses are patent. Straight sinus, internal cerebral veins and basal veins are identified and appear patent.
1.Findings are compatible with otomastoiditis associated with abscess formations and osteomyelitis at the left mastoid and temporal bone. Please refer to CT of the temporal bone for additional comments.2.There is no evidence for intracranial abscess at this time. There is also no evidence for dural venous thrombosis.3.MR venogram of the brain is within normal limits