Fig. 2.
(A) and (B) MRI on admission. High signal on diffusion weighted imaging (DWI) sequence and low signal on the corresponding ADC map in the petrous apex compatible with restricted diffusion suggests underlying infection (arrowheads). (C) MRI on admission. Axial T1 fat-saturated contrast-enhanced image shows peripheral enhancement (arrow) around the hypointense fluid suggesting pus. Features are in keeping with an abscess in the petrous apex. In addition, there is abnormal enhancement extending adjacent to the cavernous sinus (arrowhead). (D) MRI on admission. Coronal T1 fat-saturated contrast-enhanced image shows thickening and enhancement of the dura around the entrance to Meckel's Cave (arrow).