Blurry vision and pituitary tumor. The lesion does not appear to exert mass effect upon the optic apparatus. There is enlargement of the pituitary gland, which measures up to 15 mm overall. There does not appear to be mass effect upon the adjacent optic apparatus. There is expansion of the sella with protrusion inferiorly into the sphenoid sinuses. The mass also protrudes slightly into the cavernous sinuses. In addition, the posterior pituitary bright spot is displaced superiorly and the pituitary stalk is deviated to the left. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is diffuse cerebral volume loss, with disproportionate involvement of the medial temporal lobes. There are multiple foci of cerebral white matter T2 hyperintensity. The major cerebral flow voids are intact. The orbits are grossly unremarkable.
1. A pituitary tumor may represent an adenoma, but is incompletely characterized due to the lack of intravenous contrast. The lesion does not appear to exert mass effect upon the adjacent optic apparatus.2. Diffuse cerebral volume loss, with disproportionate involvement of the medial temporal lobes, which may indicate Alzheimer's disease.3. Multiple foci of cerebral white matter T2 hyperintensity are nonspecific, but may represent the results of chronic small vessel ischemic disease. 