Clinical question: Assess for llH, rule out mass/tumor. Signs and symptoms: Headache that is worse with sneezing, bowel movement/stranding and razing arms above head. Pre-and post-enhanced brain MRI:Diffusion-weighted images are severely distorted due to metallic artifact likely from patient's braces. No gross areas of acute ischemic change.Examination demonstrates normal signal intensity and morphology of the cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.The signal void of major intracranial arterial branches are identified.There is no evidence of abnormal parenchymal, leptomeningeal, calvarial or orbital enhancement.The signal intensity of intracranial venous sinuses is again normal and normal pattern of enhancement.Paranasal sinuses cannot be assessed due to significant metallic hardware artifact.
Negative pre-and post enhanced brain MRI.