Clinical question: Evaluate intracranial process. Signs and symptoms: Weakness Non-enhanced CT brain:The examination demonstrates an extra-axial high density mass in the basal cistern measuring approximately 13.8 mm x 14.5-mm on sagittal reformatted image 26. On axial image 7 this mass measured 8 mm in the AP axis and 12.5 mm in transverse axis. The mass is in contact with dorsum sella and minimal apparent extension into the sella. The appearance of the lesion is suggestive of a meningioma considering its location and density on CT. Other differential diagnosis of pituitary macroadenoma, craniopharyngioma and very less likely aneurysm should be considered. This finding requires further dedicated MRI examination of pituitary region for better evaluation. This finding is not associated with any associated adjacent brain parenchyma abnormality.There is no evidence of intracranial hemorrhage, edema, mass effect or midline shift.There are small foci of low attenuation in the subcortical white matter of bilateral cerebral hemispheres which are nonspecific however it could represent minimal small vessel disease. The cortical sulci and ventricular system are more pronounced than is expected for patient's stated age of 69. Similar observation of the folia of the cerebellum is also made.Calvarium is intact. Mastoid air cells, middle ear cavities and visualized paranasal sinuses are unremarkable.
1.No evidence of acute intracranial finding.2.Minimal small vessel disease of indeterminate age.3.Well demarcated high-density mass in the basal cistern with minimal extension into the sella as described. Differential diagnosis of meningioma, craniopharyngioma, pituitary macroadenoma should be considered. Follow-up with a dedicated MRI of pituitary region is recommended.