Diagnosis: Unqualified visual loss, right eye, normal vision left eyeClinical question: vision loss both eyesSigns and Symptoms: optic nerve pallor, bilateral MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.No abnormal enhancing mass lesions are appreciated within the brain parenchyma. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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 demonstrate some mucosal thickening in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.MRI orbits:The eyeballs are intact. No intraconal or extraconal space mass is identified. The extraocular muscles are intact. The lacrimal glands are symmetric and within normal limits in size and configuration. There is no optic nerve enhancement appreciated. The suprasellar cistern is intact .Some minor thickening of the superior aspect of the infundibulum of the pituitary gland is nonspecific, however, it extends into the center of the optic high as in.
1.There is minimal thickening of the superior aspect of the infundibulum of the pituitary gland extending to the optic chiasm. This a nonspecific finding but may represent some minor or early inflammatory effect (such as granulomatous lesion or other infiltrating lesion). Please correlate with clinical history and findings.2.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. They are most likely vascular related.