Findings:
Approximately 12 x 12 x 16 mm measuring lesion within the right cavernous sinus with signal void on the T2w sequences and heterogenous enhancement on the postcontrast study, suspicious of a large carotid cave aneurysm. The pituitary gland and the pituitary stalk are deviated to the left. No obvious suprasellar mass lesion or chiasmal compression.
Moderate background small vessel ischaemic disease. Mild involutional changes of the brain are noted. No hydrocephalus or midline shift.
Bilateral IOL-implants are noted. Partial obliteration of the mastoid air cells is seen on the right. The mastoid air cells on the left are clear.
Minimal mucosal thickening is seen in the right maxillary sinus. The paranasal sinuses are otherwise clear.
No bony abnormality is seen.
Impression:
Approximately 12 x 16 mm measuring lesion within the right cavernous sinus, primarily in keeping with a large carotid cave aneurysm on the right. Further evaluation with CT/MRI angiography and neurovascular referral is advised.
No obvious evidence of a pituitary aneurysm.