What is the key finding on the non-contrast CT?
Enlarged opthalmic veins
Given this finding, what is the most likely diagnosis?
What is the best next investigation?
CT angiography. Non-invasive and will be able to better define vascular abnormality.
Non-contrast CT of the brain demonstrates no parenchymal abnormality. There is however some increased density within the sella turcica. The superior ophthalmic veins are prominent.
Windowing to bone demonstrates erosion of the sella, with protrusion of soft tissue material into the sphenoid sinus.