21 years Female (DOB:10/10/1995)Reason: pituitary cystic lesion, enlarge in Sep 2015 w possible hemorrhage associated with headache, also has infratentorial lesion. History: normal vision and endocrine functionPROVIDER/ATTENDING NAME: ISSAM A. AWAD ISSAM A. AWAD MRI brain:There is a 32 x 36 mm sagittal dimension and 52 x 36 mm axial dimension cystic mass in the posterior fossa compatible with arachnoid cyst associated with bone remodeling which appears largely unchanged when compared to the previous exam it follows spinal fluid on all pulse sequences.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 right sigmoid sinus appears to be absent. The left sigmoid sinus is large. The straight sinus is relatively small. The right transverse sinus is smaller than the left transverse sinus. The right transverse sinus appears to drain into vein of Labbe.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI pituitary:There is redemonstration of a T1 hyperintense focus in the inferior aspect of the pituitary at the midline is unchanged compared to prior exam. It measures approximately 2 mm in size.The pituitary gland is appropriate in overall height and morphology. The infundibulum of the pituitary gland is midline. The cavernous sinuses are intact bilaterally.
1.Stable pituitary lesion which could represent a Rathke's cyst.2.There is a compatible with an arachnoid cyst in the posterior fossa which is stable compared to the prior exam.3.Findings suggest congenital absence or hypoplasia of the right sigmoid sinus.