Acute on top of chronic headache. Known to have bitemporal hemianopsia previously.
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There is a large mass, centered at the sella, expanding the bony sella into the sphenoid sinuses, extending superiorly to fill the suprasellar cistern. The optic chiasm is obviously compressed superiorly and explains the patient's visual complaint. Also it goes posteriorly and causes splaying of the cerebral peduncles.
Different signal intensities are obtained from this lesion. Peripherally, it's slightly hyper intense on T1 and T2 images and enhances following contrast administration. Centrally, there is a large fluid-blood level, consistent with an acute hemorrhagic process into this mass.