Reason: history of seizure and AVM History: seizure in 1980's MRI of the brainThere is a 38 x 19 mm sagittal dimension sellar and suprasellar mass which displaces the optic chiasm superiorly.There is subcortical signal hyperintensity on T2 and flair MRI along the inferior and lateral aspect of the right postcentral gyrus is also adjacent right inferior parietal lobule.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. There is adjacent widening of sulciNo abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening of the minor opacities. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebrovascular occlusion.The anterior communicating artery is identified. The posterior communicating arteries are not readily identified. The vertebral arteries are similar in size.
1.There is a large sellar and suprasellar mass which displaces the optic chiasm superiorly. This most likely represents pituitary adenoma. Prior studies are not available for comparison.2.There is encephalomalacia present along the right parietal lobe as detailed above3.There is no evidence for a true venous malformation this exam. Please note that conventional angiography is more sensitive in detection of residual arteriovenous malformation.4.An alphanumeric page was sent to pager 2356 (Sandra Rose) at the time of this dictation. The findings were discussed.