Orbital cellulitisClinical question: assess after ENT decompressionSigns and Symptoms: s/p abscess drainageEpidural abscess There is redemonstration of ring-enhancing fluid collection along the left superior lateral aspect of the orbits which extends from the extraconal space to the preseptal space and superficial to the left cerebral orbital rim. It measures 15 x 25 mm axial dimensions. In general it appears larger on the current MRI exam relative to the prior CT exam. There is associated infiltration along the left extraconal space. The distance between the interzygomatic line and the left eye lens is approximately 21 mm.There is vacuum and meningeal enhancement present adjacent to the left frontal lobe. There is enhancement present across the left superior orbital roof. There is some leptomeningeal enhancement adjacent to the left frontal lobe.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate partial opacification of the left-sided paranasal sinuses more than the right sided paranasal sinuses. The visualized portions of the mastoid air cells demonstrate partial opacification of the mastoid air cells.
1.There is a left orbital abscess present centered in the left superior lateral aspect of the left orbit preseptal space at the expected location of the lacrimal gland which extends across the left extraconal space including the superior aspect of the extraconal space as well as the subcutaneous tissues surrounding the left orbit. 2.There is associated with the pachymeningeal and leptomeningeal enhancement adjacent to the left frontal lobe suggesting possible intracranial extension with meningitis.3.Findings are suspicious for proptosis on the left side.4.There are inflammatory changes present within the left ethmoid air cells and the left maxillary sinus which were also present on the prior exam and likely related to sinusitis