Legend CT images through the orbits (top) demonstrate proptosis on the right, haziness of the intraconal and extraconal fat extending to the orbital apex, and enlargement of the medial rectus. Abnormal soft tissue (bottom left image) is also demonstrated within the retromaxillary fat, and changes in the superficial soft tissues of the face are noted. Opacification of the paranasal sinuses is evident. Coronal images through the sella (bottom right) reveal no enhancement of the right cavernous sinus.

Legend Proptosis, edema within the intraconal fat and medial rectus are confirmed on the axial T2 MR image (top left). Swelling of the overlying soft tissues is evident. MR angiogram (top right) demonstrates patent carotid arteries bilaterally. Bottom right images through the cavernous sinuses show deficient enhancement in the right cavernous sinus, suggesting thrombosis.

Legend FLAIR (left images) and diffusion (center) demonstrate abnormality in the medial temporal and occipital lobes, with involvement of the right pons, thalamus, internal capsule and globus pallidus, consistent with infarct. Moderate amount of mass effect is present. Also note the abnormal tissue in the right prepontine cistern. The patient is status post right orbital exenteration with a right anterior and posterior ethmoidectomy and right sphenoidotomy. Source and MIP images of an MR angiogram (right) reveal apparent occlusion of the right cavernous internal carotid artery. No signal is seen in the right posterior cerebral artery beyond the P1 segment consistent with occlusion. Key words: ct mr mri infection inflammation orbit paranasal sinuses

ENT & Brain Diagnosis: 1. Rhinocerebral mucormycosis 2. Cavernous sinus thrombosis 3. Right carotid occlusion 4. Cerebral infarct