Female, 24 years old, with headache and tremor. Concern for CADASIL. Diffusion imaging is unremarkable. A single focus of nonspecific FLAIR hyperintensity is seen within the orbital gyrus of the left inferior frontal lobe. No other significant parenchymal signal abnormality, edema or mass effect is observed. No acute intracranial hemorrhage or any abnormal extra-axial fluid collections are seen. The ventricles are normal in size and morphology. There may be a small cystic structure within the posterior aspect of the sella, incompletely evaluated on this exam. The osseous structures of skull show normal signal characteristics. A mucous retention cyst is present in the right maxillary sinus.
1.No findings are seen to account for the patient's symptoms. In particular, no imaging evidence of CADASIL is present.2.There appears to be a small cystic structure within the posterior aspect of the sella. This lesion is incompletely evaluated on the present study, but could represent a Rathke cleft cyst or some other intrinsic pituitary lesion. If clinical concern warrants, dedicated pituitary imaging can be considered.