NB: the last sequences are centred on the paranasal sinuses and are "blown up".
Osteoma measuring 3.1 x 2.5 x 2.8 cm with lobulated irregular border on the left side of the frontal sinus, expanding through the sinus's posterior border and indenting and compressing the adjacent brain.
Polypoid mucosal thickening in all paranasal sinuses and nasal cavity, excluding the sphenoid sinus which is occluded and full of fluid. The polypoid ethmoidal mucosa invades the nasal cavity on both sides. No evidence of bone destruction.
Bilateral orbital contents are normal.
Diffuse periventricular and discrete white matter microangiopathy, the latter scattered in all cerebral lobes with peripheral predominance. Small right frontal non-acute infarct.
No abnormal focal finding in the posterior fossa.
No intracranial blood products and no acute ischemia causing restricted diffusion.
No pathological intracranial enhancement after gadolinium injection. Normal signals from the intracranial arteries and veins. Prominent atheromatous plaques in the right vertebral artery and cavernous-supraclinoid internal carotid arteries, more so on the right with wall thickening.
Free craniocervical junction.
In summary;
Large left frontal sinus osteoma and sinonasal polyposis.
Supratentorial microangiopathy.