PMC6744721_01
(a) Axial noncontrast head computer tomography showing significant bilateral frontal horn, third and fourth ventricular hemorrhage. (b) Sagittal noncontrast head computer tomography showing third and fourth ventricular hemorrhage. The lateral ventricles are not well visualized here, but some intraventricular hemorrhage is still seen.
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F1
The brain computer tomography (CT) revealed a suprasellar cistern and anterior interhemispheric SAH with IVH; this required placement of a right ventricular drain [Figure 1].
Magnetic resonance imaging brain, sagittal T1-WI with contrast shows a large sellar mass with suprasellar extension. Mass measures 3.5 cm x 1.7 cm.
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F2
There was also an invasion of the right cavernous sinus, protrusion into the sphenoid sinus, and mass effect on the optic chiasm [Figure 2].
Magnetic resonance imaging sella, sagittal T1-WI with contrast shows a large, enhancing sellar/suprasellar mass extending into the third ventricle. Significantly enlarged compared to prior imaging, no measuring 5.7 cm x 2.9 cm.
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F3
The MRI now showed a significant interval increase in the size of the sellar/suprasellar enhancing mass with the invasion of the cavernous sinus and encasement of the internal carotid arteries bilaterally [Figures 3 and 4].
Magnetic resonance imaging sella, coronal T1-WI with contrast shows the mass now extending into the bilateral cavernous sinuses, right greater than left, and encasing the internal carotid arteries.
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F4
The MRI now showed a significant interval increase in the size of the sellar/suprasellar enhancing mass with the invasion of the cavernous sinus and encasement of the internal carotid arteries bilaterally [Figures 3 and 4].