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ke/sb/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzi Shilmn / M / 45 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

C/O altered behaviour with diminished vision since 2 months.
Known alcoholic.

EXAMINATION :

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.

3 mm thick STIR coronal images through the optic nerves.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is a large area in the left temporo-occipital region which is iso to hypointense to CSF on the T1 Weighted images and is seen to turn hyperintense on the proton and T2 Weighted images. Hyperintense areas are noted adjacent to this lesion on the proton and T2 Weighted images which would represent gliosis. There is dilatation of the occipital horn of the left lateral ventricle and this lesion would represent an area of cystic encephalomalacia.

Hyperintense areas are noted in the periventricular deep white matter, pons and the right corona radiata and centrum semiovale. These are hypointense to the normal white matter on the T1 Weighted images suggestive of areas of ischemia/infarction.





Lacunar infarcts which are nearly isointense to CSF on all the pulse sequences of varying sizes are seen in the fronto-parietal deep white matter, right corona radiata and centrum semiovale, right cerebellar hemisphere, right occipital white matter and bilateral thalami.

Dilated perivascular spaces are seen in the lentiform nuclei bilaterally.

The optic nerves show normal signal intensity on the STIR images.

There is mild to moderate dilatation of both the lateral ventricles with fullness of the third and the fourth ventricles. There is slight prominence of the cerebral cortical sulci and cerebellar folia. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.

IMPRESSION :

1. An area of cystic encephalomalacia in the left temporo-occipital region, the sequelae of previous vascular insult.

2. Altered signal in the periventricular deep white matter, pons and the right corona radiata and centrum semiovale are suggestive of areas of ischemia/infarction.

3. Lacunar infarcts in the fronto-parietal deep white matter, right corona radiata and centrum semiovale, right cerebellar hemisphere, right occipital white matter and bilateral thalami.


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