Clinical question: Is there evidence of bleed. Signs and symptoms: Headaches. Non-infused CT brain:Examination demonstrates no evidence of intracranial hemorrhage.Patchy foci of nonspecific low-attenuation in the periventricular and subcortical white matter are present. Although nonspecific the findings are suspected for small vessel disease of indeterminate age. Further follow-up with an MRI is recommended. There is no evidence of edema, mass effect, midline shift or hydrocephalus.High density mass in the sella with extension superiorly into the basal cistern is concerning for pituitary macroadenoma. Dedicated MRI examination of the sella is also recommended for further evaluation. Calvarium, paranasal sinuses and mastoid air cells are unremarkable.
1.Pituitary macroadenoma.2.Small vessel disease of indeterminate age.3.Follow-up with an MRI is recommended for above findings.4.No evidence of acute intracranial process.