Cognitive decline, please assess for volume loss, CVD: memory loss. There is disproportionate prominence of the third and lateral ventricles with a substantial CSF flow jet within the third ventricle. There appears to be a rounded subcentimeter area of CSF signal in the right anterior portion of the third ventricle that appears to be sharply demarcated from the CSF flow artifact. In addition, there is disproportionate volume loss affecting the medial temporal lobes bilaterally. There is mild periventricular white matter T2 hyperintensity. There is a relatively hypoenhancing lesion in the right pituitary lobe that measures up to 14 mm in craniocaudal dimension, without evidence of mass effect upon the optic apparatus. There is no evidence of intracranial hemorrhage or acute cerebral infarction. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. Findings suggestive of Alzheimer's disease perhaps with superimposed normal pressure hydrocephalus.2. A lesion in the pituitary gland likely represents a macroadenoma.3. An apparent rounded subcentimeter area of CSF signal in the right anterior portion of the third ventricle that appears to be sharply demarcated from the CSF flow artifact, may be an artifact itself versus an arachnoid cyst or colloid cyst. If necessary, follow up with DRIVE or FIESTA sequences through this region may be useful for further elucidation.4. No evidence of acute intracranial hemorrhage or acute cerebral infraction.Discussed with Dr. Mastrianni at 1:30 PM on 3/26/15.