61 years Male (DOB:1/1/1955)Reason: OR prep History: epidermoid tumorPROVIDER/ATTENDING NAME: KRISTINA K SICKER SERVICES ANCILLARY The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 10 mm lesion present within the left side of the pituitary fossa which bulges into the left cavernous sinus.There is an irregularly-shaped cystic appearing lesion present in the posterior fossa which extends from the fourth ventricle inferiorly and bulges into the posterior aspect of the medulla. It measures approximately 37 x 18 mm axial dimensions.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.The lesion centered in the inferior aspect of the fourth ventricle which extends through foramen of March, and bulges into the medulla. It has a cystic appearance. One possibility is that this represents an epidermoid. Please correlate clinical history and symptoms and prior imaging.2.There is a left sided pituitary fossa lesion present. Please correlate clinical history and symptoms and prior imaging. Most commonly lesions in the pituitary gland represent adenomas.3.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 4.Please note that this is a limited exam for the purpose of stereotactic guidance. Please refer to any previous imaging studies that may have been done for further comments