Clinical question: Chronic headache, history of left mastoidectomy. Signs and symptoms: Chronic headaches. Pre-and post-enhanced brain MRI:Unremarkable diffusion weighted series.Examination demonstrates a normal anatomical development/morphology brain parenchyma. There is normal signal intensity brain parenchyma on all MRI sequences. Unremarkable cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.Post enhanced images are negative for any abnormal parenchymal, leptomeningeal or calvarial enhancement. There is however a visualization of enhancement of the right frontal small developmental venous anomaly without interval change since prior exam.There is interval significant improvement of post operative changes are left-sided mastoidectomy.Normal signal intensity of all paranasal sinuses, right mastoid air cells and bilateral middle ear cavities. Pre-and post enhanced MRV:The examination demonstrates normal intracranial venous sinuses without evidence of abnormal caliber or in the regions of concern. Bilateral internal cerebral veins, vein of Galen, bilateral veins of Labbe and overall the entire superficial cortical veins remain within normal.
1.Pre-and post enhanced brain MRI demonstrate no evidence of any acute or new finding since prior exam. Unremarkable exam and with revisualization of a small right frontal mental venous anomaly. Interval improvement of post operative changes left mastoidectomy.2.Negative for pre-and post enhanced MRV.