Date : 00.00.00
Name of the Patient : Abc XyzAli lmn / F / 40 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
Operated for a suprasellar and planumsphenoidal meningioma on 00.00.00. Patient developed right hemiparesis, 1 episode of seizure and diminished vision in the right eye. Also C/O drowsiness and fever off and on.
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.
5 mm thick T1 Weighted sagittal images.
There is evidence of a right frontal craniotomy with post-operative changes in the soft tissues in the right frontal region. A small, epidural collection is also noted in the right frontal region, deep to the craniotomy flap.
There is seen an ill-defined, hyperintense signal on the proton, T2 Weighted and FLAIR images in the right inferior frontal cortex, left para-third ventricular region and left cerebral peduncle. These lesions appear hypointense to normal grey matter on the T1 Weighted images.
There is a small, subdural CSF intensity lesion on all the pulse sequences in the left fronto-temporo-parietal region which represents a small subdural hygroma.
There is an ill-defined, hyperintense signal on the T1 Weighted images in the suprasellar cistern, which remains hyperintense on the proton and T2 Weighted images. The pituitary stalk is not well-identified from the lesion which is seen to indent the optic chiasma to the left of the midline. The pituitary gland is well identified on the present study. The cavernous sinuses on either side are unremarkable.
There is mild fullness of both the lateral ventricles. The third and the fourth ventricles are normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Inflammatory changes are noted in the mastoid air cells bilaterally.
1. Post-operative status.
2. Altered signal in the right inferior frontal cortex,
left para-third ventricular region and left cerebral peduncle as described, most likely represent ischemic changes (The inferior right frontal lesion may be due to previous surgery).
3. Altered signal in the suprasellar cistern, more to the left of the midline, may represent haemorrhage/hemostatic material like gel foam, in the given clinical setting.
4. A small, subdural CSF intensity lesion on all the pulse sequences in the left fronto-temporo-parietal region may represent a small subdural hygroma.
- 3 - Scan-00001
As compared to the previous MRI (study no:00002) dated 00.00.00,
there is no significant change in the size of the ventricles on the present study. The post-operative epidural collection and subgaleal collection in the right frontal region have also decresed in size. The intensity of the ischemic lesion in the left parathird ventricular lesion and left cerebral peduncle has also decreased.
There is however slight increase in the size of the subdural hygroma in the left fronto-temporo-parietal region.