70 year-old male presenting with transient alteration of awareness and ataxia, with likely TIA. Evaluate for bleed or other cause. There is no evidence of intracranial hemorrhage, mass or edema. Soft tissue mass extending from the sella is identified, incompletely evaluated without contrast administration, resulting in mass effect upon the suprasellar cistern. No internal calcifications or adjacent bone erosion is evident. Further evaluation with MRI is recommended. The ventricles are midline, and demonstrate normal volume and morphology.The calvaria and skull base are radiographically normal. Crescentic high density is noted in the subcutaneous tissues along the superior aspect of the left parietal lobe, which may represent hematoma. No underlying fracture is evident. Partial opacification of the maxillary and sphenoid sinuses and numerous ethmoid air cells is evident.
1. Subcutaneous hematoma overlying the postero-superior left parietal bone, with no underlying fractures or intracranial hemorrhage. 2. Sellar mass as described above. Differential considerations include pituitary macroadenoma, among others. Further evaluation with MRI is recommended. 3. Sinus disease as described above.