ke/bv/nl/nl







Name of the Patient : Abc Xyzahan A.Relmn / F / 2 1/2 yrs.
Referred by : Dr. Abc Xyzance Nursing Home.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures with left III nerve palsy and left ptosis.

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.

3 mm thick T2 Weighted coronal images.

2.5 mm thick T1 Weighted coronal images.

After administration of contrast, the following parameters were used :

5 mm thick T1 Weighted axial and coronal images with
magnetization transfer.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a small, well-defined lesion in the right cerebellar hemisphere which appears hypointense on all the pulse sequences. Minimal perilesional edema is noted. This lesion measures approximately 1.0 x 0.9 cms. A similar, but smaller lesion is noted in the left cerebellar hemisphere.
Scan-00007

A lacune (iso to hyperintense to CSF) is seen within the right thalamus.

There is mild to moderate dilatation of both the lateral and third ventricles with periventricular CSF ooze. Turbulent flow is noted within the posterior third ventricle and aqueduct.

The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this scan.

After administration of contrast, there is a conglomeration of ring and disc enhancement of the lesion in the right cerebellar hemisphere. Disc enhancement is noted in the left cerebellar hemisphere. Basal enhancement is also noted especially in the peripontine and perimesencephalic and suprasellar cistern. Subtle disc enhancement is seen in the right frontal region and left frontal parafalcine region.

Mega cisterna magna is noted.

IMPRESSION :

The MRI features are suggestive of granulomas in the cerebellar hemispheres bilaterally, right frontal lobe basal exudates (meningitis) and dilatation of both the lateral and third ventricles. A lacune in the right thalamus is probably a sequelae to vasculitis. These features most probably are due to an infective process like tuberculosis.