Case Notes
History
11 month male admitted for gastroenteritis, treated with antibiotics, but has persistent fever and irritability.Exam
MR flair
Prior Study
Noncontrast, T2-w spin-echo MR1. CNS volume loss with increased intracranial CSF spaces. It is these changes are most consistent with persistent post meningitic, low grade, external hydrocephalus.
2. Fluid opacification of the both otomastoid sinuses of indeterminate state; there are no features to confirm active coalescent mastoiditis.
Sagittal post contrast MR
1. There are changes consistent with the subacute or chronic phase of leptomeningitis. The small subdural hygromas and subtle residual dural and pial enhancement is most consistent with residual subacute or later effects of leptomeningitis. Whether there is residual active infections cannot be determined from the imaging.