Conversation: The conversation between human and AI assistant.
[|Human|] 10 weeks ago I had a concussion. First MRI showed normal while 2nd MRI showed a spot on the putuitary gland which I was told possible benign tumor. I am confused why the first report is normal while the 2nd is now showing this spot. I am still having the dizziness and headaches while starting to feel a little muscle weakness in my upper body with a lot of fatigue. What would be my options?
[|AI|]  I read your question carefully, and I understand your concern. I imagine you are a little irritated of it not having been diagnosed on first MRI. One explanation might be that the 2nd MRI unlike the 1st included contrast administration and that evidenced the tumor. Contrast sequences aren't always done, not considered necessary for a concussion. Also, there are some special sequences for pituitary gland, and they are done only when there is a clinical suspicion not for concussion evaluation. Another explanation may be simply that it was missed. When the radiologist evaluates the MRI he pays more attention to certain things depending on indication and pituitary gland is not an area commonly involved by trauma, so small things may have been missed if one doesn't look specifically for them. As for what to do that depends on what effect does that tumor has. Pituitary gland produces many hormones, so now lab test for hormonal levels is necessary. Afterwards depending on hormonal level alterations and whether the tumor causes any compression to surrounding structures a decision will be made whether to consider surgery or follow up and medication. I remain at your disposal for other questions.