38-year-old male with right upper weakness status post transoral resection of pituitary adenoma Restricted diffusion with matching ADC hypointensity, T1 hypointensity, and T2 hyperintensity is noted involving the leftward mid brain including the left cerebral peduncle. Changes from transsphenoidal surgery are again noted with residual pituitary mass containing central hemorrhagic products with upper bowing the optic apparatus, grossly unchanged from the recent postoperative pituitary MRI given the current brain acquisition technique. The ventricular system is unremarkable. There are no extra-axial fluid collections. Expected vascular flow voids are demonstrated.
Acute to subacute ischemia involving the leftward mid-brain including the left cerebral peduncle. Results were discussed with the emergency room team caring for the patient on 8/5/2016 at 1:18 PM.