Idiopathic pachymeningitis. There is diffuse mass-like dural thickening and enhancement along the posterior aspect of the clivus with extension into the upper cervical spinal canal at the level of the dens, measuring up to 12 mm in thickness, which is not significantly changed. There is also unchanged associated mass-effect upon the medulla. There is no evidence of intracranial hemorrhage or acute infarct. The brain parenchymal signal and pituitary gland appear unremarkable. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
No significant interval change in the retroclival idiopathic pachymeningitis with extension into the upper cervical spinal canal and the associated mass-effect upon the medulla.