case_images: PMC10589032_01
case_images: Sinus CT without contrast showed moderate left maxillary sinusitis with narrowing of the left osteomeatal unit with mucosal disease.
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case_images: CT scan of the head (Fig. 1) revealed mucosal disease in the left maxillary sinus and sphenoid sinus with abnormal soft tissue in the pterygopalatine fissure extending into the orbital apex.
case_images: MRI orbit with and without contrast showing aggressive sinus inflammatory process with evidence of bone destruction through the left pterygopalatine fossa.
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case_images: A follow-up MRI of orbit and brain (Fig. 2) was obtained which showed aggressive sinus inflammatory process within the posterior aspect of the left maxillary sinus with evidence of bone destruction and invasion through the left pterygopalatine fossa, left middle cranial fossa into epidural space, and left orbital floor into intraconal space.
case_images: MRI brain with contrast demonstrating peripheral enhancing collection in left anteromedial temporal lobe measuring 11 x 8 x 11 mm appearing more organized and well-defined. Although not seen in this view, an additional peripherally enhancing lesion measuring 4 x 7 x 6 mm was visualized along the posterior lateral margin of the collection.
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case_images: f3-jchim-13-05-065
case_images: After the procedure, an MRI of the head was repeated which showed post-operative changes with a redemonstration of the epidural abscess in the left middle cranial fossa (Fig. 3).