Pituitary tumor surveillance and history of prior infarcts. Pituitary: There are postoperative findings related to transsphenoidal surgery. There is an enhancing mass arising from the pituitary that measures up to 19 mm in craniocaudal dimension, previously 16 mm. The tumor protrudes into the left cavernous sinus, but there is no encasement of the carotid artery flow voids. There is also thickening of the infundibulum, which measures up to 6 mm in width. The tumor abuts the right prechiasmatic optic nerve. There is mild mucosal thickening in the sphenoid sinuses.Brain: There are subcentimeter foci of encephalomalacia in the right pons and basal ganglia. There is also an area of encephalomalacia in the right cerebellar hemisphere. There is a background of scattered T2 hyperintense foci in the cerebral white matter. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles are unchanged in size and configuration, with a cavum septum pellucidum and vergae. There is no midline shift or herniation. The major cerebral flow voids are grossly intact. The orbits, skull, and scalp soft tissues are grossly unremarkable.
1. Interval increase in size of the pituitary macroadenoma.2. Chronic right pons, right cerebellar hemisphere, and right basal ganglia lacunar infarcts superimposed upon a background of chronic small vessel ischemic disease.