Clinical question: Craniosynostosis, with new headaches, evaluate for change. Signs and symptoms: New headaches. Nonenhanced brain MRI:Unremarkable diffusion weighted images.Examination demonstrates extensive minimal metallic artifact from prior craniosynostosis surgery without evidence of any intracranial associated abnormalities.There is normal anatomical development of brain parenchyma and with normal signal intensity on all MRI sequences.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.The signal voids of major intracranial arterial branches are identified and unremarkable.The signal intensity of the intracranial venous sinuses are unremarkable.Unremarkable images through the orbits.Extensive opacification of the right chamber of the sphenoid sinus consistent with sinusitis and unremarkable rest of paranasal sinuses. This finding could explain patient's new headaches.
1.Unremarkable nonenhanced brain MRI.2.Expected chronic changes of prior craniosynostosis operation without intracranial associated abnormalities.3.Extensive opacification of the right chamber of the sphenoid sinus and left posterior ethmoid and unremarkable other paranasal sinuses. This finding could explain patient's headaches. Bilateral mastoid air cells and middle ear cavities remain well pneumatized.