Hyperpneumatisation of mastoid air cells
Hx of benign intracranial HTN, obese. Presented with 2/12 swelling R. occipital region, 2/52 tenderness. No new headaches/trauma/discharge. No fever. No ALOC. Hx of repititive valsalva manouvre as a habit.
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Excessive pneumatisation of the mastoid air cells extending along occipital bone including condyle, clivus, petrous apex on R. Loculated air collection in scalp overlapping parietal, occipital with internal septae.
Also into mandibular fossa, prevertebral, parotid space.
Air pockets extending to extradural space at the craniovertebral junction, anterior to occipital condyle and through hypoglossal canal. Loculated septated collection in extradural space in parieto-occipital region causing mass effect on brain parenchyma.
Partial empty sella syndrome (type 1) and CSF along optic nerve sheaths in keeping with benign intracranial HTN.