ke/bv/rg/nl
Date : 00.00.00

Name of the Patient : Abc XyzDhlmn / F / 22 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O loss of vision with forgetfullness since 1 month.
Similar episode 8 years ago.

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 coronal images.
3 mm thick STIR coronal images through the optic nerves.
5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There are ill-defined hypointense areas in the left occipito-parietal region and in the right temporo-parieto-occipital region on the T1 Weighted images with involvement of the optic radiation bilaterally. These are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. There is loss of underlying white matter with focal prominence of the atrium of the left lateral ventricle. An area following CSF characteristics is observed in the right temporal lobe.

There are hyperintense areas in the periventricular deep white matter in the fronto-parietal regions bilaterally on the proton, T2 Weighted and FLAIR images. These are iso to hypointense to normal white matter on the T1 Weighted images.

There is thinning of the corpus callosum with involvement of the genu and splenium.





There is fullness of the ventricular system. There is prominence
of the cerebral cortical sulci and the cerebellar folia bilaterally. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

The optic nerves show normal signal intensity on the STIR images.

Incidental note is made of bilateral maxillary sinusitis.

IMPRESSION :

Nearly symmetric white matter changes in the left occipito-parietal and right temporo-parieto-occipital regions and periventricular deep white matter in the fronto-parietal regions bilaterally also to some extent involving the grey matter with thinning of the corpus callosum, tissue loss and cerebral and cerebellar atrophy is not specific for a single etiology.

This probably represents a long standing demyelinating disorder or neurodegenerative disorder. Subacute sclerosing panencephalitis should be ruled out. Possibility of ischemic lesions seems less likely.