23 years, Female, headache, status post epidural on 5/14, having significant headaches. Status post blood patch x2, no resolution in pain.. Brain: There is diffusely increased dural enhancement without nodularity. There is no abnormal intraparenchymal signal abnormality or enhancement. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. No restricted diffusion to suggest acute ischemia. Major flow-voids are preserved. Pituitary gland is prominent in size measuring up to 12 mm in the craniocaudal dimension, but likely within normal limits for age and peripartum state. No focal lesions or hemorrhage. There is a mucus retention cyst in the right maxillary sinus as well as minimal mucosal thickening involving the left maxillary sinus. Paranasal sinuses and mastoid cells are otherwise clear. Bone marrow signal and remainder of the extracranial soft tissues are within normal limits. MRV head: No evidence of venous sinus stenosis. Major superficial and deep venous structures are patent.
1. There is diffusely increased dural enhancement which can be seen with intracranial hypotension and compatible with history of recent intrathecal puncture. Brain MRI is otherwise unremarkable. No subdural hematoma or extra-axial collections. 2. No evidence of venous sinus thrombosis.