Headache, vertigo, positive head impulse, and nystagmus on right vision. MRI: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain, brainstem, cerebellum appear unremarkable. There is a flattened appearance of the pituitary gland. The ventricles, sulci, and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. However, there is a partially-imaged heterogeneous right parotid tumor measuring at last up to 20 mm.MRA: There is no evidence of significant steno-occlusive lesions in the head and neck arteries. In particular, while the vertebral arteries in the neck are tortuous, the posterior circulation nevertheless appears to be intact. There is no evidence of cerebral saccular aneurysms.
1. No evidence of acute intracranial hemorrhage, mass, or acute infarct.2. No evidence of significant steno-occlusive lesions in the head and neck arteries. 3. A partially-imaged right parotid tumor measuring at last up to 20 mm may represent a pleomorphic adenoma, for example. Follow up with dedicated parotid imaging may be useful.4. A flattened appearance of the pituitary gland is nonspecific and can represent a normal variant or a sign of elevated intracranial pressure, for example.