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Focal swelling and restricted diffusion (confirmed as low signal on the ADC map) in the splenium of the corpus callosum and white matter of the parietal lobes.
Note underlying right frontal and maxillary sinusitis (fluid levels) with swelling in the adjacent right frontal lobe indicative of cerebritis. Diffuse pachymeningeal thickening and enhancement over the right hemisphere with a small subdural empyaema overlying the right frontal lobe extending parafalcine on the right. There is also patchy leptomeningeal enhancement.
Findings are consistent acute sinustitis and extension of infection into the cranial cavity involving the dura and leptomeninges producing a thin subdural empyaema. Cerebritis but not abscess involving the right frontal lobe. Features of MERS in the splenium and white matter of the parietal lobes.