 There is acute right medial pontine ischemia. There is no evidence of acute intracranial hemorrhage. Periventricular and subcortical white matter hypodensities of a mild to moderate degree are present. Chronic right cerebellar encephalomalacia. Redemonstration of dominant left vertebral artery. Patient is status post trans-sphenoidal pituitary surgery. Pituitary lesion is slowly increasing in size over several prior studies. There is infiltration into the left cavernous sinus with the lesion surrounding the left cavernous internal carotid. The lesion also abuts the right medial cavernous internal carotid. There appears to be CSF between the optic chiasm and the lesion.No evidence of intracranial mass, mass-effect, or hydrocephalus. There is mild opacification of the maxillary sinuses. The imaged mastoid air cells are clear. The imaged orbits are intact. The osseous structures are unremarkable.
1.Acute right medial pontine ischemia.2.Slowly increasing pituitary lesion as above.3.Periventricular and subcortical white matter changes of a mild to moderate degree are nonspecific. At this age they are most likely vascular related. 4.Right cerebellar encephalomalacia.Findings discussed with Dr. Mendelson on 3/23/2015 at 10:30AM.