Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus [G40.219] / Neoplasm of uncertain behavior of pituitary gland [D44.3] / Epilepsy, unspecified. Re-demonstration of non enhancing hypothalamic mass with prepontine cistern extension which shows low signal intensity on T1 and slightly high signal intensity on T2/FLAIR. The size (26mm x 30mm) and MR characteristics of the lesion do not show any interval change since prior scan in 2012.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.There is evidence of right side ventriculostomy tube track, again stable since prior exam.The ventricles, sulci and cisterns are unremarkable. There is no 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 mastoid air cells are clear.There are subtle mucosal thickening on the left sphenoid sinus and left ethmoid sinuses.Pituitary gland MRIImage quality is degraded due to significant motion artifacts.The non enhancing hypothalamic mass is abutting the optic chiasm and indents pituitary stalk anterior and superiorly. The pituitary gland is not clearly visualized on this scan mainly due to motion artifacts but shows normal range of enhancement.
1. Stable non-enhancing hypothalamic mass since prior scan in terms of its measured size and MR characteristics.2. No evidence of acute ischemic or hemorrhagic lesion on this scan.