Presentation
Headache, fever and facial pain
Patient Data
Expansion and opacification of paranasal sinuses (involving frontal, anterior and posterior ethmoid air cells, maxillary and sphenoid sinuses), which show hyperdense content, bone remodeling marked thinning and eroded wall more prominent in posterior sphenoid sinuses, which is indenting the prepontine cistern posteriorly.
Thickening of nasal turbinates obliterating the nasal cavity.
Obliteration of paranasal sinuses, displaying intermediate to high signal in T1W and heterogeneous signal in T2W images, markedly hypointense, pseudo-pneumatization sign on T2W images.
Thin mucosal enhancement of paranasal sinuses, but lack of enhancement in the sphenoid sinuses, which are indenting the prepontine cistern, and are abutting the basilar artery.
Obliteration of the nasal cavity, Polypoidal extension of inferior turbinates into the nasal cavity.
No clear extension into brain parenchyma.
Case Discussion
Opacification of paranasal sinuses with hyperdense material in CT study, with intermediate signal in T1W images and pseudo-pneumatization sign in T2W images in MRI study, lack of mucosal enhancement denoting invasion outside sinuses, and suggestive of allergic fungal sinusitis.