Benign intracranial hypertension [G93.2], Reason for Study: ^Reason: meningeal enhancement History: encephalopathy Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion on the scan.Bilateral I globes appear to be slightly flattened on the posterior aspect, however, there is no definitive MR evidence of buckling of optic nerves on the scan.Suprasellar cistern appear to be slightly expanded however, pituitary gland are seen and appears to maintain normal size.Minimal expansion of extra-axial CSF spaces especially bilateral hemisphere.On gadolinium enhancement, there are diffuse patchy meningeal enhancement which may indicate post lumbar puncture status, clinical correlation is recommended.Multifocal scattered T2/FLAIR high signal intensity lesions are seen on bilateral periventricular white mater which most likely represent non specificThe ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate an aneurysmal dilatation of the left cavernous sinus segment directing superior and left laterally (6mm x 10mm) and fusiform ectasia of the left cavernous sinus segment itself (largest diameter is about 8mm) and total length of 14mm. There is about 2.3mm sized right cavernous sinus segment of ICA.Bilateral MCAs and ACAs appears to be normal.Vertebrobasilar system appears to be normal.
1. Slightly flattened bilateral eye globes, expanded suprasellar cistern and bihemispheric extra axial fluid collections suggest possible diagnosis of intracranial hypertension. The pachymeningeal enhancement might be related to prior lumbar puncture procedure, clinical correlation is recommended.2. Fusiform aneurysmal dilatation of the left ICA cavernous sinus segment with associated 6mm x 10mm sized cavernous sinus segment aneurysm.3. 2.3mm sized right cavernous sinus segment aneurysm of ICA. 