Neuro_CT_Facial_Bones: 3 F, right periorbital swelling.

CLINICAL HISTORY: 3 years of age, Female, right periorbital swelling.

FINDINGS:

There is mild right orbital proptosis. There is right periorbital soft tissue swelling and enhancement which extends to involve the right temporal fossa and temporalis muscle and the postseptal right lateral extraconal space. There is a nonenhancing lesion involving the right greater wing of the sphenoid and lateral orbit measuring approximately 7 x 11 mm in transaxial dimensions. This is associated with a tract that extends superficially from the lesion to the right lateral supraorbital soft tissue and skin. There is mild enhancement of the right lateral orbital wall. There is thin linear enhancement along the right anterior temporal lobe which either represents reactive dural thickening or congestion of the sphenoparietal sinus. No gross intracranial extension is identified.

The cerebellar tonsils are low-lying and positioned 15 mm below the foramen magnum with resulting deformity of the cervical medullary junction. The brain is otherwise preserved in signal intensity.

There is mild asymmetric ventriculomegaly, right greater than left. No periventricular edema is identified

The visualized paranasal sinuses and mastoid air cells are clear.

IMPRESSION:

1.  Nonenhancing lesion involving the right greater wing of the sphenoid and lateral orbit with restricted diffusion and increased perfusion with associated tract extending superficially to the overlying skin may represent dermoid/epidermoid. Associated edema and enhancement of the right periorbital soft tissues with extension to the right temporal fossa and postseptal right lateral extraconal space may represent superimposed infection/inflammation. Thin linear enhancement along the right anterior temporal lobe either represents reactive dural thickening or congestion of the sphenoparietal sinus. No intracranial extension is identified.

2.  Cerebellar tonsils are positioned 15 mm below the foramen magnum with resulting deformity of the cervical medullary junction. Mild asymmetric (right greater than left) ventriculomegaly.