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Date : 00.00.00

Name of the Patient : Abc Xyz Ylmn / F / 13 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O brain-stem glioma detected in December 0000. On AKT since September 0000. Received 30 sittings of radiotherapy.
For follow up.
C/O headaches, diplopia and imbalance while walking since 1 1/2 months.

EXAMINATION :

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

5 mm thick T1 Weighted, proton and T2 Weighted axial images.
4 mm thick FLAIR coronal images.
3 mm thick T1 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.
MR cisternogram was obtained in the sagittal plane.

OBSERVATION :

There is a large ill-defined, hypointense area in the posterior aspect of the pons on the T1 Weighted images which is seen to turn hyperintense on the proton, T2 Weighted and FLAIR images. Few hypointense areas which are slightly hyperintense to CSF are seen within the lesion on the T1 Weighted images and are hyperintense on the T2 Weighted images in the posterior aspect of the lesion and would represent cystic/necrotic changes. Inferiorly this lesion is seen to extend upto the ponto-medullary junction and superiorly upto the junction of the upper pons and lower midbrain. There is mass effect with compression of the anterior aspect of the fourth ventricle. There is effacement of the peripontine cistern.

There is mild fullness of both the lateral ventricles. The third ventricle is normal. No obvious vascular anomaly is identified on this study.
..2/.








IMPRESSION :

In a known C/O brain-stem glioma, the MRI features are suggestive of a large ill-defined mass lesion in the pons with extensions as described.

As compared to the previous MRI (scan no.0000) dated 00.00.00,
there is slight increase in the size of the lesion. The cystic/necrotic component appears to be reduced.

The atria of the ventricles also appear slightly full.
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