Diagnosis: Migraine, unspecified, without mention of intractable migraine without mention of status migrainosus. Headache(784.0)Clinical question: Eval for sarcoid lesionsSigns and Symptoms: headaches MRI brain:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.MRI pituitary:The pituitary gland is appropriate in overall height. There is asymmetry in the appearance of the pituitary gland with a 3mm lesser enhancing focus along its left inferior aspect. There is a scalloped appearance to the adjacent bone. The infundibulum of the pituitary gland is midline and within normal limits.. No suprasellar or intrasellar mass is identified. The cavernous sinuses are intact bilaterally.
1.No abnormal lesions are appreciated intracranially that are suggestive of neurosarcoid. The infundibulum of the pituitary gland is within normal limits.2.There is some asymmetry in the appearance of the pituitary gland which is nonspecific with a 3mm lesser enhancing focus along the left half of the pituitary gland. This is non-specific. Please correlate with patient's endocrine findings.