Reason: Left trigeminal neuralgia Please note that MRI of the complete brain was not obtained as this was done per an IAC protocol as requested.There is a mass occupying the sella, right cavernous sinus and large portion of the clivus consistent with patient's known macroadenoma. There is no significant change in size and extent of the lesion, with the bulk of the lesion measuring 2.0 x 1.5 cm (1101/1), previously 2.0 x 1.6 cm on remeasurement. Additional reference measurements cannot be made as the coronal postcontrast sequences do not include the entire extent of the tumor. No mass effect of the tumor on either the left Meckel's cave or cavernous sinus. No abnormal enhancement along the left trigeminal nerve.Enhancement of the pituitary stalk and deviation to the left aspect of the sella is unchanged. Unchanged downward tenting of the chiasm consistent with postsurgical change. Flow voids are intact. No evidence of diffusion restriction to suggest acute infarct. Orbits and skull are grossly unremarkable. Mild mucosal thickening of the ethmoid sinuses.
Pituitary macroadenoma which involves the right cavernous sinus is unchanged. MRI IAC demonstrates no abnormal enhancement or mass effect along the course of the left trigeminal nerve to explain patient's symptoms. 