As seen in the previous CT, there is a large subdural collection, which is high on T2, low on T1, demonstrating peripheral enhancement, and restricted pattern on DWI. The collection extends along the tentorium on both sides, associated with extensive adjacent dural and leptomeningeal enhancement. Demonstrated again are: the mass effect, rightward subfalcine and left sided uncal herniation as well as sinusitis. No evidence of tonsillar herniation.
A small oval shaped peripherally enhancing collection is seen in the left gyrus rectus, with adjacent dural enhancement and restricted diffusion, could represent a small intraparenchymal abscess or part of the subdural empyema.
Imaging appearances are those of extensive subdural empyema with mass effect and left sided uncal herniation.