Pneumosinus dilatans frontalis
Recurrent headaches with gait abnormality. Patient is easily forgetful.
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There is incidental finding of hyperpneumatization of both frontal sinuses, more on the right. No thinning of the sinus bony walls.
Atrophic changes of the cerebellum with prominence of the folia is evident. The midbrain and pons are somewhat reduced in size with consequent ex-vacuo dilatation of the 4th ventricle. The cerebrum is unremarkable.
Pneumosinus dilatans frontalis refers to enlargement of the frontal sinus. This rare disorder may affect all paranasal sinuses, but frontal sinus involvement is most common.
The etiology and pathogenesis of this condition remain undetermined. Pneumosinus dilatans frontalis has been linked with anterior skull base meningioma 1. It is also seen in Dyke-Davidoff-Masson syndrome, which has been associated with cerebral hemiatrophy.
Diffuse cerebellar atrophy has varied causes including alcoholic cerebellar degeneration, ataxia telangiectasia, olivopontocerebellar atrophy, Friedreich ataxia, prolonged exposure to phenytoin among other conditions.