Extensive leptomeningeal enhancement most conspicuous on post contrast axial FLAIR imaging is evident within the sulci of the frontal, parietal sulci, cerebellar folia and anterior to the medulla.
No intra or extra axial mass, haemorrhage or collection. No parenchymal signal abnormality evident. No diffusion restriction to suggest recent infarction. Normal appearance of mid-sagittal structures.
No evidence of hydrocephalus.
The dural venous sinuses remain patent with no evidence of venous sinus occlusion or thrombosis.
Conclusion: Extensive supra and infratentorial leptomeningeal enhancement consistent with meningitis of multiple aetiologies with infective (including atypical organisms such as TB and cryptococcus), inflammatory (neurosarcoid) and haematological malignancies. Correlation with CSF is recommended.
No parenchymal disease or dural venous sinus thrombosis.