Date : 00.00.00
Name of the Patient : Abc Xyzh Mitlmn / M / 55 yrs.
Referred by : Dr. Abc Xyzrani.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O right frontal oligodendroglioma. Operated in May 0000. Received chemotherapy (2 cycles) and radiotherapy (20 sittings). Re-operated for recurrence in October 0000. Recovered.
Now C/O gait imbalance, memory loss, loss of control over bladder/bowel since January 0000.
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 T2 Weighted coronal images.
5 mm thick T1 Weighted sagittal images.
There is evidence of a right frontal craniotomy. An epidural collection having a maximum width of 0.8 cms is seen deep to the craniotomy site which is isointense to CSF on all the pulse sequences. There are diffuse areas of hypointensity on the T1 Weighted images which turn hyperintense on the proton and T2 Weighted images in the right frontal lobe. Few areas which are iso to hyperintense to CSF on all the pulse sequences are noted within this lesion and would represent cystic/necrotic changes. There is effacement of the cerebral cortical sulci.
This lesion is seen to be extending into the genu of the corpus callosum on the right side. Also seen is mild indentation and postero-inferior displacement of the frontal horn of the right lateral ventricle. There is mild bulging of the anterior falx to the left side.
There is moderate dilatation of both the lateral, third and the fourth ventricles with periventricular CSF ooze. The basal cisternal spaces are unremarkable. No obvious vascular anomaly is identified on this study.IMPRESSION :In a known C/O oligodendroglioma, status post-operative, the MRI features are suggestive of a residual/recurrent lesion in the right frontal lobe with post-operative cystic/necrotic changes and extensions as described.As compared to the previous MRI (study no:0000) dated 00.00.00, there is slight decrease in the bulk of the lesion. There is moderate dilatation of the ventricular system with periventricular CSF ooze. An epidural collection is noted at the site of the right frontal craniotomy.