 BRAIN: There is no acute infarct, mass effect, or cerebral edema. There are few nonspecific punctate white matter T2 hyperintense foci in the bilateral frontal white matter. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There is retroflexion of the dens tip effacing the ventral CSF. The lower brain stem/upper cervical cord is somewhat draped along the dens, and there is resultant mild mass effect on the inferior cerebellar tonsils and vermis. There is mild resulting crowding of soft tissue of the foramen magnum without Chiari I malformation.PITUITARY: The pituitary gland is not enlarged. There is homogeneous enhancement of the pituitary gland without focal lesion. The posterior pituitary T1 hyperintense focus is present. The cavernous sinuses symmetrically enhance. The pituitary stalk is not deviated. There is no mass effect on the optic chiasm.
1.No evidence of pituitary lesion.2.Retroflexion of the dens tip with draping and displacement of the lower brain stem/upper cervical cord posteriorly with secondary mild mass effect on the inferior cerebellar tonsils and vermis. There is also mild crowding of structures at the foramen magnum without Chiari I malformation. It should be noted that this exam is a static exam. Therefore, this appearance may change with changes in positioning of the head. Please correlate clinically.3.Few punctate nonspecific white matter signal abnormalities in the frontal lobes.