 There are multiple punctate foci of T2 hyperintensity in bilateral frontal and parietal lobe subcortical white matter locations without restricted diffusion, enhancement, or susceptibility abnormality. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mild mucosal thickening is present in the left axilla sinus. The remaining paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain. Redemonstrated are changes from previous transsphenoidal approach pituitary tumor resection. Multisequence hyperintensity within the right aspect of the sella likely represents susceptibility related to chronic blood product and/or mineralization. The residual pituitary gland is heterogeneous and small. The pituitary infundibulum enhances normally and is deviated towards the right. The suprasellar space is clear and there is no impingement upon the optic apparatus. These findings are unchanged.
1.There are multiple punctate foci of T2 hyperintensity in bilateral frontal and parietal lobe subcortical white matter locations without restricted diffusion, enhancement, or susceptibility abnormality. These are nonspecific in appearance but abnormal for a patient aged 43 years. The differential diagnosis would most likely include small vessel disease or migraine sequelae and less likely residua from prior head trauma or from vasculitides. Given lesional appearance and locations, demyelination is unlikely.2.Stable MRI findings status post resection of a pituitary mass. The residual pituitary gland is small and heterogeneous, unchanged in appearance.