 There is no acute infarct, mass effect, or cerebral edema. There is a rounded 6-mm low T2 signal abnormality within the left aspect of the pituitary gland seen best on series 501 image 11. There are multiple scattered periventricular and subcortical white matter T2 hyperintense lesions which are nonspecific. There are no lesions in the posterior fossa. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is moderate opacification of the right maxillary and left sphenoid sinuses representing inspissated secretions. The skull and extracranial soft tissues are unremarkable.
1.No acute infarct.2.6-mm low T2 signal abnormality within the left aspect of the pituitary gland may represent a small adenoma, Rathke's cleft cyst, focus of old hemorrhage or other etiology. If there are signs/symptoms referable to the pituitary gland, then further evaluation with MRI pituitary gland without and with contrast would be recommended.3.Multiple nonspecific scattered periventricular and subcortical white matter T2 hyperintense lesions. Differential diagnosis includes vascular related etiologies (which would be advanced for patient's age), chronic headaches, demyelination and prior infectious/inflammatory etiologies.