 There are scattered punctate foci of T2 hyperintensity within the white matter without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement. There are no similar appearing foci in the posterior fossa.There is a 2-3 mm focus of relative hypoenhancement within the mid aspect of the anterior pituitary which is slightly T2 hyperintense. The pituitary gland height remains normal, and there is no involvement of the adjacent optic apparatus.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Mucosal thickening is present within the maxillary sinuses. Scattered foci of mucosal thickening can be found in bilateral ethmoid air cells. The remainder of the paranasal sinuses and mastoid air cells are clear. There is no abnormal enhancement within the brain.
1.There are scattered punctate foci of T2 hyperintensity within the white matter without associated mass effect, restricted diffusion, susceptibility abnormality, or enhancement. There are no similar appearing foci in the posterior fossa. This is nonspecific in appearance and the differential diagnosis would most likely include migraine sequela, small vessel disease, residua from prior head trauma, or demyelination.2.There is a 2-3 mm focus of relative hypoenhancement within the mid aspect of the anterior pituitary which is slightly T2 hyperintense. The pituitary gland height remains normal, and there is no involvement of the adjacent optic apparatus. This is suggestive of a pituitary microadenoma, which could be confirmed with dedicated pituitary MRI imaging and/or correlation with thyroid hormone levels.