Soft tissue is seen filling up the left middle ear cavity with air fluid levels in left mastoid air cells. Diffuse edema and post gadolinium contrat hyperenhancement is seen involving >60% of clivus with surrounding posterior nasopharyngeal wall edema, enhanement around left Eustachian tube, involving left occipital condyle, left jugular foramen and left hypoglossal canal.
Absent flow voids in mid superior sagittal sinus, entire left transverse sinus, left sigmoid sinus, left jugular vein. Meningeal thickening and hyperenhancement seen in the posterior margin of left middle cranial fossa floor.
Inflamed left maxillary and the sphneoid air cells.