A 7mm defect at the medial floor of the right middle cranial fossa with inferomedial herniation of the right fusiform gyrus and underlying meninges is demonstrated. Cystic changes are demonstrated within this herniated part of the brain, most likely secondary to cystic gliosis. The right sphenoid sinus is fluid filled.
There is almost complete opacification of the left maxillary sinus with moderate mucosal thickening, and minor right ethmoidal mucosal thickening.
There are multiple areas of increased T2 signal within the deep white matter and in the periventricular region in keeping with chronic ischaemic change. Within some of these lesions, areas of decreased T2 signal is seen within the centre and are consistent with old lacunar infarcts.
Findings are in keeping with a post traumatic encephalomeningocoele through the medial floor of the right middle cranial fossa communicating with the right sphenoid sinus.