right side numbness. Multifocal restricted diffusion lesions on the left thalamus, parahippocampal gyrus and occipital lobes implying the left PCA territorial ischemic infarctions. Post enhancement scan shows diffuse enhancement of pituitary gland and linear non nodular dural enhancement on the clivus. The size of pituitary gland is about 8.2mm x 10.3mm with demonstrating upward bulging. However there is no discrete mass or mass like lesion is identified. These findings suggest possible pituitary hyperplasia but could be a normal range of postmenopausal woman. Thus, if clinically indicated, further evaluation through endocrinological review/investigation can be considered.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.
1. Acute ischemic infarctions on the left PCA territory without evidence of hemorrhagic transformation. Further evaluation for intracranial arterial system especially focused on posterior fossa is recommended using head and neck CTA.2. 8mm x10mm homogeneously enhancing pituitary gland without evidence of discrete mass, could indicate pituitary hyperplasia or upper normal range of pituitary gland size.3. Dural enhancement of clivus could represent dural lesions such as meningioma, tumor or inflammatory infiltration or non specific. 