Headache [R51] / Other visual disturbances [H53.8], Reason for Study: ^Reason: 73 yo F admitted with bilateral uveitis, HA, blurry vision, possibly vasculitis on CT chest, eval for GCA and any other cause of HA/blurry vision History: bilateral eye redness Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion.On Gad enhanced scan, bihemispheric diffuse dural enhancement are seen. This diffuse pachymeningeal enhancement indicate possible dural irritation including meningitis, or some dural infiltrative lesions such as metastasis or lymphoma. Or this can also be seen after lumbar puncture. Intracranial hypotension can also show dural enhancement, however, there is no other supporting imaging evidence on this scan. Clinical correlation is recommended.There are about 6-8mm thickness extra axial fluid collections on bilateral frontal convexities. These fluid collections are non enhancing and follows CSF signal intensity. There is no evidence of mass effects against underlying brain parenchyme. There are also evidence of susceptibility lesions on dependent portion especially on the left side. Few vascular signal voids within those fluid collections are also seen. These lesions may indicate subdural hygroma. There are scattered somewhat patchy FLAIR/T2 high signal intensities on bilateral white matter. These are non specific but at this age could represent small vessel ischemic disease.The 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 normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.
1. Diffuse pachymeningeal enhancement, diagnostic possibilities include meningitis, infiltrative lesions or post lumbar puncture status.2. Bilateral frontal convexity extra axial CSF collections, may represent subdural hygroma.3.Non specific scattered T2/FLAIR high signal intensity lesions.4. No evidence of acute ischemic or hemorrhagic lesion.5. Normal brain MRA 