Reason: adrenal insufficiency History: short gut, TPN dependence, poor growth, normal GLT stim test and centreal adrenal insufficiency MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images, predominantly on the left side.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI pituitary:The pituitary gland is appropriate in overall height and morphology. The infundibulum of the pituitary gland is midline. No suprasellar or intrasellar mass is identified. The cavernous sinuses are intact bilaterally.
1.No abnormal lesion is identified in the pituitary gland. The pituitary is normal in overall size and morphologic appearance.2.Punctate periventricular white matter lesions of a mild degree are present which are nonspecific. Given the patient's PMH, they are most likely are perinatal in origin.