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Date : 00.00.00

Name of the Patient : Abc Xyzji Malmn / F / 35 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O seizures since 5 years.

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.

After administration of contrast, 5 mm thick T1 Weighted axial and coronal images (with magnetization transfer) and 5 mm thick T1 Weighted sagittal images were obtained.

OBSERVATION :

There is seen a diffuse, ill-defined, hypointense lesion on the T1 Weighted images in the left fronto-temporo-parietal region, involving the cortex and subcortical white matter. This lesion appears hyperintense on the proton, T2 Weighted and FLAIR images. Resultant effacement of the cerebral cortical sulci in the left cerebral hemisphere is noted. There is indentation and compression of the left lateral and third ventricles with mild shift of the midline to the right. Left sided uncal herniation is also noted, with indentation on the left cerebral peduncle and slight distortion of the upper brainstem axis. There is also seen a diffuse ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the left parieto-occipital, parafalcine region, in the periventricular white matter bilaterally and in the corpus callosum. This signal appears iso to hypointense to normal white matter on the T1 Weighted images.

The right lateral and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is slight prominence of the cerebellar folia bilaterally. No obvious vascular anomaly is identified on this study.

After administration of contrast, there is no focal or diffuse area of abnormal enhancement in the brain parenchyma or along the meninges.

- 2 -


A polyp is noted in the left maxillary sinus.

The tip of the odontoid process is directed slightly posteriorly.

IMPRESSION :

Diffuse, non-enhancing, altered signal intensity lesion in the left fronto-temporo-parietal region and in the left parieto-occipital, parafalcine region as described, is not specific for a single etiology. This most likely represents a glial cell tumor.

Diffuse altered signal in the periventricular white matter bilaterally and in the corpus callosum as described may also represent glial cell lesion.

Gliomatosis cerebri may be considered as a likely possibility.




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