The question: Patient with a 5 month history of headache worst when upright, better while lying down. Signs and symptoms: As above. Weight loss and dysphasia. Pre-and post enhanced brain MRI:No diffusion weighted abnormalities identified.There is normal anatomical morphology of brain and with normal signal intensity on all MRI sequences.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal. The signal voids of major intracranial arterial branches are identified. Post enhanced images demonstrate no detectable abnormal enhancement or brain parenchymal, leptomeninges, calvarium or the orbits.The signal intensity of the intracranial venous sinuses are within normal and with normal pattern of enhancement.Calvarium and soft tissues of the scalp demonstrate no abnormalities.Mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.Paranasal sinuses are well pneumatized and there is a small right inferior maxillary sinus retention cyst.
1.Negative pre-and post enhanced brain MRI.2.Unremarkable paranasal sinuses, well pneumatized mastoid air cells and middle ear cavities.3.Unremarkable calvarium, soft tissues of the scalp and orbits.