Secondary or tertiary adrenal insufficiency, evaluate pituitary and hypothalamus. BRAIN: The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathologic enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. A mucous retention cyst is present within the right maxillary sinus. The orbits, skull, paranasal sinuses, and scalp soft tissues are otherwise grossly unremarkable.PITUITARY: Dedicated images through the sella demonstrate that the pituitary appears slightly small, however, this could reflect normal variation. No focal abnormal signal intensity or mass is seen within the pituitary gland. The pituitary stalk lies in the midline. Suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear unremarkable.
1.No evidence of acute intracranial hemorrhage, mass, or acute infarct.2.No pituitary lesions identified. The pituitary appears slightly small, however, this could simply reflect normal variation.