MRI study some time later
Evidence of prior right pterional craniotomy with small subdural fluid collection and thickening of the dura.
Large extraaxial mass is evident, involving the right cavernous sinus and extending medially into the pituitary fossa and a large rounded component bulging laterally into the right middle cranial fossa. Pituitary tissue appears separate from the lesion. Overall dimensions are 35mm AP, 45 mm transverse and 40 mm SI, not significantly changed from previously.
There is marked crowding of structures at the orbital apex and mild right proptosis is evident.
Moderate compression of the right side of the optic chiasm, which is compressed against the right hypothalamic region. The mass has increased T2 signal and enhances reasonably homogeneously post administration of contrast. The cavernous segment of the right internal carotid artery appears encased in narrow and there is displaced inferolaterally by the mass, the right M1 segment is displaced anterior to the mass. The mass has raised cerebral blood volume and increased lactate. Evidence of prior infarction/haemorrhage in the right striatocapsular region.