Date : 00.00.00
Name of the Patient : Abc Xyz Shlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzah / Dr. Abc Xyzmpat.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O headaches, vomiting and fever since 4-5 days.
H/O disorientation and neck rigidity.
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.
SOME IMAGES SHOW PATIENT MOTION.
There is seen an approximately 0.9 cms diameter sized well-marginated, iso to hypointense lesion on the T1 Weighted images in the left cerebellar hemisphere, just adjacent to the midline. This lesion appears relatively hypointense on the proton, T2 Weighted and FLAIR images. Perilesional hyperintense signal on the T2 Weighted and FLAIR images may represent edema. Similar signal intensity lesions are noted in the left cerebellar hemisphere adjacent to the left perimedullary cistern.
There is a small bright focus on the proton and T2 Weighted images in the left parietal deep white matter which is most likely partial volume averaging with the tip of a sulcus (? ischemic focus ? small granuloma).
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Inflammatory changes are noted in the maxillary sinuses, sphenoid sinus and ethmoidal air cells bilaterally.
Altered signal intensity lesions in the left cerebellar hemisphere, just adjacent to the midline and along the left perimedullary cistern as described, most likely represents granulomas following the signal characteristics of tuberculomas.
A contrast enhanced scan would be worthwhile.