 Again seen is is atrophy of the left caudate with volume loss of the left thalamus and in the region of the left corona radiata, internal capsule and centrum semiovale. Left cerebral peduncle is smaller compared to the right slight with asymmetric atrophy of the left pons and left medulla, related to Wallerian degeneration. There is ex vacuo dilatation of the left lateral ventricle. FLAIR hyperintensity is demonstrated along the edges of the dilated left lateral ventricle, likely related to gliosis. The lateral wall of the left lateral ventricle is irregular. There is prominence of the rest of the ventricular system with the exception of the fourth ventricle. Blood degradation products better demonstrated previously along the left caudothalamic groove and lateral ventricular margin.Corpus callosum is thinned, but fully formed. There is normal myelination. Flow-voids are seen from major intracranial vascular structures.Dedicated images of the pituitary gland demonstrate absence of the normal T1 hyperintensity associated with the neurohypophysis. Visualized pituitary gland is otherwise within normal limits for age with homogeneous enhancement. No evidence of micro-or macroadenoma. Visualized optic apparatus is unremarkable. Septum pellucidum is present.
1. Compared to 2/25/2014, no significant change in atrophy in the left basal ganglia and left frontal lobe with ex vacuo dilatation of the left lateral ventricle. Findings are consistent with remote history of grade IV IVH.2. Absence of the T1 hyperintensity of the neurohypophysis (which was present on remote MRI studies from 2012), finding which can be seen in patients with central diabetes insipidus. MR appearance of the hypothalamus, infundibulum and pituitary gland is otherwise unremarkable. 