Sinusitis

Sinusitis is an inflammation of the paranasal sinuses which can be caused by infection from bacterial, viral, allergic, fungal, or autoimmune problems.


This is a coronal fat-saturated T2 MRI image of an inflamed right side ethmoid sinus. The arrow points to the inflamed area of interest. When viewing radiology images the right side is always on the left for the person viewing the image, and the left side is on the right, as I said, the arrow is pointing to the right ethmoid sinus which is full of fluid. Fluid shows up bright on T2 weighted MRI images. The left side ethmoid sinus air cells are clear and show up black and empty.


There are several paranasal sinuses.

The ethmoid sinuses can cause pain and or pressure behind and between the eyes.

The maxillary sinuses can cause pressure in the cheek area and cause headaches or toothaches.

The Frontal sinuses can cause headaches and pain above and behind the eyes.

The sphenoid sinuses can cause dizziness and an imbalance of a persons equilibrium.

Some symptoms are, nasal congestion, fever, nasal discharge, vertigo, headache, lightheadedness, halitosis, and blurred vision.

Orbital Cavernous Hemangioma

Orital cavernous hemangiomas are the most common tumors of the orbit in adults. They are vascular malformations that are composed of large, dilated endothelium lined channel with a fibrous covering.

These tumors are slow growing, and usually occur in patients ages 30 to 40 years old, and most tend to be more common in females. Patients tend to have painless proptosis (swelling of the eyes).

On the right side of this image behind the left eye is a round dense cavernous hemangioma that may in many cases displace or otherwise push on the optic nerve.

Surgery or surgical resection is the normal treatment which produces a high cure rate.

Empty Sellar Syndrome

The pituitary gland is housed by the sella turcica, which lies inferior to the frontal lobe of the brain, and anterior to the fourth ventricle and pons. The darkest area in this MRI image just under the frontal lobe, surrounds the sella turcica which is outlined in white and looks like an incomplete circle. Inside the sella turcica is the pituitary gland, only in this case the sella turcica is filled with CSF or cerebral spinal fluid. This CSF has flattened the pituitary gland and this flattening of the pituitary gland gives the appearance of an empty sella turcica, thus the name, empty sella syndrome.

There is primary and secondary ESS.

Primary ESS is the increased pressure of CSF flattening out the pituitary gland along the interior walls of the sella turcica. Primary ESS related to obesity as well as high blood pressure in women, and can cause a build up of fluid pressure in the skull.

In secondary ESS, the pituitary gland becomes smaller, shrinking inside the Sella turcica due to some sort of injury or related surgery, and or radiation therapy. Due to an improperly functioning pituitary gland, a ceasing of menstrual periods, infertility, fatigue as well an intolerance to stress and infection may occur.

ESS in children may cause an early onset of puberty, and a low growth rate due to a deficiency in producing growth hormones.

MRI scans may be the modality of choice in evaluating ESS.

Typically, ESS is not a life threatening disorder.

Acoustic Neuroma

Acoustic Neuroma, technically known as vestibular schwannoma, is a noncancerous benign tumor that occurs in the superior portion of the vestibular nerve which can be found in and actually is a part of the eighth cranial nerve complex. This is important as this nerve needs to be healthy for proper equilibrium or balance, as well as hearing. The name of the tumor as with most pathologies gets it's name from the anatomy involved, in this case the nerve that it affects.

In the image on the left you can see the tumor in the middle of the picture and the blood vessels surrounding it that feed it. The contrast enhanced axial image on the right highlights the tumor in the internal auditory canal. Before CT and MRI finding and diagnosis of this type of tumor was very difficult and often missed.

Signs and symptoms associated with the growth of an acoustic neuroma could include unilateral tinnitus, unilateral hearing loss, facial nerves not functioning properly, problems with cerebellar area functions, problems swallowing, and strange sensations unilaterally in the face. In cases of the tumor becoming very large, hydrocephalus, and brain stem compression could occur causing a whole array of other problems not mentioned here.