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Asked for Male | 70 Years

Pituitary Adenoma with Ischemic Changes: MRI Report

Patient's Query

Dear Sir, Below i am sending my father MRI report, kindly guide me. MRI REPORT – BRAIN WITH CONTRAST TECHNIQUE: T1W Sagittal, DWI - b1000, ADC, GRE T2W FS Axial, MR Angiogram, FLAIR Axial & Coronal Post contrast images after administration of 5 ml of gadolinium contrast. OBSERVATION: The study reveals an intrasellar mass lesion, with enlargement of the right half of the anterior pituitary gland, extending to the suprasellar cistern. The mass lesion is predominantly isointense to gray matter on T1-weighted images. On T2-weighted images the mass is predominantly isointense to gray matter with internal areas of T2 hyperintensity suggestive of ?necrosis/cystic change. Dynamic postcontrast images revealed decreased/delayed enhancement of the mass lesion as compared to the rest of the pituitary gland. The mass lesion measures 1.2 AP x 1.6 TR x 1.6 SI cm. Superiorly the mass displaces the infundibulum to the left side. A clear CSF plane of cleavage is seen between the superior aspect of the mass lesion and the optic chasm. No significant parasellar extension of the mass lesion is seen. The cavernous segment of both internal carotid arteries show normal flow void. The mass causes mild thinning of the floor of the sella turcica, with slight bulge toward the roof of the sphenoid sinus. MR findings likely represent pituitary adenoma. Confluent and discrete areas of T2/flair hyperintensity are seen in bilateral supratentorial periventricular and subcortical deep white matter, likely representing nonspecific ischemic changes with a combination of leukoariosis, microvascular ischemic changes, lacunar infarcts and prominent perivascular spaces. Basal ganglia and thalami are normal. Midbrain, pons and medulla are normal in signal intensity. The cerebellum appears normal. Bilateral CP angle cisterns are normal. The ventricular system and subarachnoid spaces are normal. No significant midline shift is seen. The cranio-cervical junction is normal. Post-contrast images reveal no other abnormal enhancing pathology. Bilateral maxillary sinus polyps are noted.

Answered by Dr. Gurneet Sawhney

THE MRI SHOWS a mass lesion in the pituitary gland. It measures 1.2x1.6x1.6 cm and causes mild thinning of the sella turcica floor . Post-contrast images reveal delayed enhancement of the mass, suggesting PITUITARY ADENOMA.. Bilateral maxillary sinus polyps are noted . ISCHEMIC CHANGES with leukoariosis, microvascular ischemia, lacunar infarcts, and perivascular spaces are present .. Basal ganglia, thalami, and brainstem are normal ..For detailed discussion and treatment plan need to visit a neurosurgeon.

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Questions & Answers on "Neurology" (529)

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Answered on 23rd May '24

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Dear Sir, Below i am sending my father MRI report, kindly guide me. MRI REPORT – BRAIN WITH CONTRAST TECHNIQUE: T1W Sagittal, DWI - b1000, ADC, GRE T2W FS Axial, MR Angiogram, FLAIR Axial & Coronal Post contrast images after administration of 5 ml of gadolinium contrast. OBSERVATION: The study reveals an intrasellar mass lesion, with enlargement of the right half of the anterior pituitary gland, extending to the suprasellar cistern. The mass lesion is predominantly isointense to gray matter on T1-weighted images. On T2-weighted images the mass is predominantly isointense to gray matter with internal areas of T2 hyperintensity suggestive of ?necrosis/cystic change. Dynamic postcontrast images revealed decreased/delayed enhancement of the mass lesion as compared to the rest of the pituitary gland. The mass lesion measures 1.2 AP x 1.6 TR x 1.6 SI cm. Superiorly the mass displaces the infundibulum to the left side. A clear CSF plane of cleavage is seen between the superior aspect of the mass lesion and the optic chasm. No significant parasellar extension of the mass lesion is seen. The cavernous segment of both internal carotid arteries show normal flow void. The mass causes mild thinning of the floor of the sella turcica, with slight bulge toward the roof of the sphenoid sinus. MR findings likely represent pituitary adenoma. Confluent and discrete areas of T2/flair hyperintensity are seen in bilateral supratentorial periventricular and subcortical deep white matter, likely representing nonspecific ischemic changes with a combination of leukoariosis, microvascular ischemic changes, lacunar infarcts and prominent perivascular spaces. Basal ganglia and thalami are normal. Midbrain, pons and medulla are normal in signal intensity. The cerebellum appears normal. Bilateral CP angle cisterns are normal. The ventricular system and subarachnoid spaces are normal. No significant midline shift is seen. The cranio-cervical junction is normal. Post-contrast images reveal no other abnormal enhancing pathology. Bilateral maxillary sinus polyps are noted.

Male | 70

Answered on 23rd May '24

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Answered on 23rd May '24

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Urgent- I am 53 old male with history of restless leg syndrome from approx. 20 years. With time it as become more severe as because I can’t sleep for many nights. By advance diagnosis doc discover i lack in dopamine production. I am having depressing thoughts .. can u give me promising treatment?

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No single "promising treatment" will work for everyone with restless leg syndrome. Commonly recommended treatments include medications, lifestyle changes, and physical therapies. Medications and treatments can be prescribed only after a proper diagnosis. Rest you should avoid caffeine, alcohol, and tobacco to reduce the severity of symptoms. Physical therapies such as stretching, massage, and yoga can help relieve muscle tension and improve sleep quality. It is also important to discuss any feelings of depression with your doctor and consider seeking therapy or counseling.

Answered on 23rd May '24

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The best solution for foot drop is usually an AFO (ankle-foot orthosis) brace. This brace helps to keep the ankle in the correct position and supports the foot, allowing you to lift it more easily. Your doctor may also recommend physical therapy or other treatments, such as electrical stimulation or surgery, to help strengthen and improve the function of the muscles in your foot and ankle.

Answered on 23rd May '24

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My son was in a bad car accident in November and he don’t move he wake up look and blink how can I help him recover? He had a brain injury called diffuse axnol injury is it a cure I have them giving him omega 3 what can cure my son? This is tearing me apart

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A diffuse axonal injury happe­ns when the brain gets shake­n in the skull. This leads to struggles with thinking, moving, and e­ven waking up. There's no quick fix, but the­rapies like physical and occupational can assist your son. Omega-3s may be­nefit brain wellness too. 

Answered on 21st Aug '24

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My wife has been recently diagnosed by one of neurologist a retinal migraine issue, she faces migraines headache in 2 or 3 months once only. Now the doctor has suggested few medicines which I think is affecting her mental health. She is prescribed with propranolol 25mg daily twice, topiramate 20 mg daily twice Due to this she always feel sleepy, dizziness, harsh behaviours, mood swings, lack of appetite, lack of focus, lack of confidence, feels awkward cannot stay awake, cannot use mobile for long time, headache affects her head daily in the evening mostly. She is using these medicine since two weeks, before she doesn't have these issue. She only had a migraine and she once had a spot in her right eye which goes after a week. But she has a small lump behind her ear which doctor mentioned it as a swellon nerve. Kindly please suggest is she getting correct treatment because her Condition is getting worse day by day in terms of mental health. She has a family history of migraine her mother and sisters.

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Propranolol and topiramate sometimes result in symptoms such as drowsiness, lightheadedness, mood changes, and an inability to concentrate. You or she must discuss this with the neurologist who prescribed these drugs because they could fix this issue by adjusting dosages or prescribing different medications that would be effective against migraines without affecting mental stability. If the lump located at the back of her ear is not yet diagnosed then it should also get checked into by the doctor to find out if there might be any connection with other signs.

Answered on 3rd June '24

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Answered on 23rd May '24

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Headache near eye/ear usually due to sinuses/eye strain. Stress, allergies, infections can trigger.OTC painkillers, rest, hydration can alleviate. In chronic cases, consult doctor. Avoid triggers, maintain healthy lifestyle. 

Answered on 23rd May '24

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