Clinical question: Evaluate for abnormality that can explain syncope. Signs and symptoms: Syncope Non-enhanced CT of brain:The examination demonstrates a mass in basal cistern. There is also suggestion of expansion of the sella on reformatted images.This mass measures approximately 19 mm times 16 -mm on axial image 7. There appears to be a second mass at the level of left cavernous sinus with no distinct communication with the mass within the basal cistern. This second mass measures approximately 12 times 17-mm in size measured on axial image 5. Although the lesion within the basal cistern may represent a pituitary macroadenoma sagittal reformatted images demonstrate residual CSF density within the sella which makes possibility of a macroadenoma less likely. And follow-up with an MRI examination is recommended. The second mass in the left cavernous sinus could represent an aneurysm or a meningioma. This also should be further evaluated with a dedicated enhanced MRI brain and an MRA.There is no evidence of intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus. The cortical sulci, ventricular system and CSF cisterns are otherwise unremarkable. The gray -- white matter differentiation is within normal.Above findings were relayed via paging tool to Dr. Kuznetsov on pager number 2782 after attempts to contact directly failed due to lack of response at the time of interpretation.
1.Mass within the basal cistern which may represent a pituitary macroadenoma. Follow up with dedicated MRI is recommended.2.Mass centered at the level of left cavernous sinus is concerning for an aneurysm, meningioma or a pituitary adenoma. It is possible that the above two masses are components of a single larger mass which should be further investigated with dedicated enhanced MRI and MRA.3.This examination is otherwise is unremarkable.