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Date : 00.00.00

Name of the Patient : Abc XyzShlmn / F / 21 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain and Intracranial and Neck M.R.A/M.R.V.

CLINICAL PROFILE :

Known C/O venous angioma in the left orbit with extension in the left cerebral hemisphere and right cerebellum.
H/O left frontal craniotomy with excision of orbital angioma in June 0000.
Received 4 sittings of sclerotherapy.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

3 mm thick T1 Weighted and FLAIR coronal images.

3 mm thick oblique sagittal images.

5 mm thick T1 Weighted sagittal images.

Intracranial and neck MRA was performed with 3D TOF and 2D TOF sequences.

OBSERVATION :

There are seen susceptibility artifacts in the left frontal region, the result of previous intervention.

There is a well-defined lesion which is seen to involve the superior rectus, medial rectus, inferior rectus and probably the superior oblique muscles which appear bulky on the T1 Weighted images. These are seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. The left eye ball is displaced antero-inferiorly.

There is a large ill-defined lesion in the left antero-lateral aspect of the upper jaw which is isointense to muscles on the T1 Weighted images and turns heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images and measures approximately 2.1 x 2.4 cms. No bony erosion or destruction is noted.

There are serpingenous flow void areas noted in the right cerebellar hemisphere, in the postero-lateral aspect of the pons, region of the inferior colliculus and in the region of vein of Galen which appears prominent and reepresents dilated vessels.

The optic nerve on the left side cannot be differentiated from the lesion. The right optic nerve shows normal signal intensity on the STIR images.

The cavernous sinuses are unremarkable.

Note is made of convex superior margin of the pituitary and which may be a normal for the patients age.

IMPRESSION :

In a known C/O lymphagioma the MRI features are suggestive of :

A well-defined lesion involving the superior rectus, medial rectus, inferior rectus and probably the superior oblique muscles.

A large ill-defined lesion in the left antero-lateral aspect of the upper jaw and measures approximately 2.1 x 2.4 cms.



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