Evaluate for hypothalamic mass: excessive daytime sleepiness. The pituitary gland is not enlarged, but the visible portions do not appear to enhance as expected and may be more T2 hypointense than usual based on the limited images of this area. Otherwise, the posterior pituitary bright spot appears to be intact and the hypothalamus appears to be unremarkable. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma appears unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
The pituitary gland is not enlarged, but it does not appear to enhance as expected based on the limited available images of this area, which may be due to partial volume averaging effects or the presence of a cystic lesion, such as a Rathke cyst. Otherwise, the posterior pituitary bright spot appears to be intact and the hypothalamus appears to be unremarkable. Nevertheless, follow up via a dedicated pituitary MRI may be useful.