Neuro_MR_Orbits: 4 M, eye pain and fever

MRI BRAIN AND ORBITS WITH AND WITHOUT CONTRAST:

CLINICAL HISTORY: 4 years of age, Male, eye pain and fever.

FINDINGS:

There is extensive mucosal thickening in the paranasal sinuses, most notable in the right ethmoid air cells with complete opacification and significant enhancement. There is a subperioteal abscess underlying the right lamina papyracea measuring 5 x 8 x 16 mm (transverse by craniocaudal by anteroposterior). There is surrounding intraorbital inflammatory changes, with edema and swelling of the medial rectus and superior oblique, lateral displacement of the medial rectus muscle abutting the optic nerve sheath with slight effacement. No definite optic nerve signal abnormality. There is mild fat stranding in the medial orbit. There is also significant edema in the right periorbital soft tissues, without drainable fluid collection.

The globes are symmetric and without abnormal signal. 

The optic chiasm is intact. 

Bilateral mastoid effusions. 

 

The crista galli and foramen cecum are intact. 

 

The brain is without abnormal signal. 

There is no ventriculomegaly. 

There is no mass, hemorrhage, or acute infarction. 

 

IMPRESSION: 

 

1.  Right orbital cellulitis, likely extension of sinus disease through lamina papyracea, with associated 5 x 8 x 16 mm subperiosteal abscess. Edema and enhancement of the right superior oblique and right medial rectus with mass effect on the right optic sheath without optic nerve signal abnormality. Periorbital soft tissue inflammatory changes without superficial drainable fluid collection. No intracranial extension.