Name of the Patient : Abc Xyzyalmn / M / 55 yrs.
Referred by : Dr. Abc Xyzdar.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

Alleged H/O RTA with loss of consciousness since then.

EXAMINATION :

M.R.I. of the brain was performed using the following parameters:

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
5 mm thick FLAIR and 7 mm thick Fast scan (T2*) coronal images.
5 mm thick T1 Weighted sagittal images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the inferior frontal and fronto-temporal regions bilaterally. These lesions predominantly appear iso to hypointense to normal white matter on the T1 Weighted images. Focal hyperintense signal on the T1 Weighted images which appear relatively hypointense on the Fast Scan images are noted within some of these lesions, which suggest early subacute haemorrhage.

There is a small bright focus on the proton, T2 Weighted and FLAIR images in the right globus pallidus/posterior capsular region which appears isointense on the T1 Weighted images and this may represent a shearing injury/an ischemic lesion.
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A linear hyperintense signal on the proton, T2 Weighted and FLAIR images in the midbrain on the right along its lateral margin and in the left posterior parietal parafalcine cortex. These lesions also appear nearly isointense on the T1 Weighted images and most likely represents shearing injuries.

There is prominence of the subdural space in the fronto-parietal regions bilaterally, larger on the right side, with a maximum width of about 6.0 mms.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebral cortical sulci bilaterally. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

Soft tissue is noted in the paranasal sinuses bilaterally and in the mastoid air cells bilaterally which may either suggest hemosinus or inflammatory sinus disease.

Subgaleal contusion is noted in the left fronto-temporal region.

IMPRESSION :

1. Altered signal in the inferior frontal and fronto-temporal regions bilaterally most likely represent contusion in the given clinical setting of trauma. There is evidence of early subacute haemorrhage in some of these lesions.

2. Altered signal in the right globus pallidus/posterior capsular region may represent a shearing injury or an ischemic lesion.
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3. Altered signal in the midbrain on the right along its lateral margin and in the left posterior parietal parafalcine cortex most likely represents shearing injuries in the given clinical setting of trauma.

4. Small subdural hygromas in the fronto-parietal regions bilaterally, larger on the right side, with a maximum width of about 6.0 mms.

5. ? hemosinus ?? inflammatory paranasal sinus disease.

6. Subgaleal contusion in the left fronto-temporal region.