81 year old female with headaches and right double vision with right horizontal gaze. Evaluate for etiology of headache and recent vision changes; assess for possible pituitary mass/lesion. MRI Brain:There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is mild prominence of the pituitary gland for the patient's age but this is probably within normal limits. No focal abnormal signal intensity or mass is seen within the pituitary gland. The pituitary stalk lies in the midline. The suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear unremarkable. There is mild patchy periventricular and subcortical T2/Flair white matter hyperintensity which is nonspecific but likely related to the sequela of chronic small vessel ischemic disease. There are not masses or abnormal enhancement in the brain. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1.No evidence of a mass or abnormal enhancement within the brain or pituitary.2.Mild chronic small vessel ischemic disease.