Date : 00.00.00
Name of the Patient : Abc Xyzma H. Jailmn / F / 20 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O headaches since 1 year with diplopia since 1 month and weakness of the LUE.
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.
4 mm thick T1 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.
PATIENT REFUSED CONTRAST ADMINISTRATION.
There is evidence of a space occupying lesion within the thalamus, hypothalamus, and right cerebral peduncle and extending into the lower midbrain and upper pons. This lesion is relatively hypointense to grey matter on all the pulse sequences. Perilesional edema is noted, which is also seen to extend into the right middle cerebellar peduncle, right cerebellar hemisphere, right lentiform nucleus, posterior limb of the right internal capsule and right corona radiata.
The lesion appears to be extending along the right optic tract. There is compression upon the third ventricle with shift to the left side and upon the body of the right lateral ventricle with resultant superior displacement. Also seen is slight compression upon the aqueduct and fourth ventricle. There is mild to moderate dilatation of both the lateral ventricles with periventricular hyperintensities on the proton, T2 Weighted and FLAIR images suggestive of CSF ooze.
No obvious vascular anomaly is identified on this study.
The MRI features are suggestive of a mass lesion in the right thalamus and right cerebral peduncle with obstructive hydrocephalus as described.
This most likely represents a neoplastic process like a glial cell tumor (especially in view of the right optic tract involvement).
The possibility of this being a granulomatous lesion is less likely. However a contrast enhanced scan may be worthwhile.