 The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. Incidental note is made of a partially empty sella. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Fluid is present within bilateral mastoid air cells. The paranasal sinuses are clear. Incidental note is made of a small postinflammatory cyst in the midline nasopharynx (aka Tornwaldt cyst). There is no abnormal enhancement within the brain.
Fluid is present within bilateral mastoid air cells which may be causing the patient's severe headaches. Otherwise negativeMRI of the brain including gadolinium enhancement.