6-year-old with history of allergies and chronic frontal headaches x 10 months. Increasing frequency, duration with fevers and conjunctivitis. Evaluate for intracranial lesion/sinusitis. CT of brain.Examination demonstrates focal area of low attenuation in the left high convexity anterior frontal lobe (images 32 and 33). This finding is nonspecific and could represent a small area of encephalomalacia of undetermined etiology. Possibility of edema cannot be ruled out and I recommend further evaluation with a dedicated infused MRI of brain.CT of paranasal sinuses.The frontal sinuses are not pneumatized. The sphenoid sinus remains within normal limits. Ethmoid sinuses are essentially unremarkable.Minimal patchy areas of mucoperiosteal thickening consistent with chronic inflammatory sinus disease of maxillary sinuses are noted. The right osteomeatal unit of the maxillary sinus is occluded secondary to mucoperiosteal thickening. The left osteomeatal is also suspected of being occluded secondary to mucoperiosteal thickening over this region is not very well visualized.
1.The small superficially located foci of low attenuation in the left frontal lobe as detailed. Unremarkable CT of brain otherwise. Follow-up MRI is recommended.2.Minimal chronic inflammatory sinus disease of maxillary sinuses with occluded OMUs.