Findings:
No intra- or extra-axial mass lesion or collection is identified.
Diffuse pachymeningeal thickening is seen in both cerebral hemispheres with no obvious fluid collection.
On the sagittal images there is sagging brainstem with reduced mamillopontine distance.
The pituitary gland appears to be prominent.
No fluid can be identified within the optic nerve sheaths.
Few, non-specific T2/FLAIR hyperintense foci are seen in bilateral cerebral white matter. The brain parenchyma is otherwise unremarkable. No oedema.
No abnormal signal on the susceptibility-weighted images or diffusion/ADC images.
The paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction is normal.
Impression:
Diffuse pachymeningeal thickening and sagging of the midbrain, suggestive of intracranial hypotension.