PNR Head 14
History
3 yo F with new seizure, fever
Major Findings
- Multispatial facial emphysema including in the extraconal soft tissues
- Multifocal sinus disease
- Preserved gray-white differentiation, but diffuse loss of sulci, which could indicate cerebral edema or meningeal process
Teaching Points
Although sulcal effacement usually represents cerebral edema, it can sometimes be due to meningeal debris (such as pus) filling and radiographically obscuring sulci.
In this patient with fever and diffuse sinus disease, infection is an important consideration. On subsequent MRI, this patient was found to have meningitis.
Important pertinent negatives on this exam include no hydrocephalus and no ventricular debris (which if present would suggest ventriculitis).
Accession: CL0677
Study description: Head^PEDS_ROUTINE_PEDS_HEAD_0_6YO (Child)
