Date : 00.00.00
Name of the Patient : Abc Xyzlmn / F / 51 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O speech disturbance since 3-4 months.
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.
3 mm thick T2 Weighted sagittal images.
Artifacts due to dentures are noted.
There is evidence of a plaque-like lesion along the meninges, posterior to the clivus and extending upto the C2 vertebral level. This lesion is of intermediate signal intensity on the T1 Weighted images and turns hypointense on the T2 Weighted images. There is mild indentation upon the cervico-medullary junction by this lesion.
Few foci of hyperintensity on the proton, T2 Weighted and FLAIR images are noted within the white matter in the frontal lobes bilaterally. These are iso to hypointense to normal white matter on the T1 Weighted images and are most likely ischemic in etiology.
An area of hypointensity on the T1 Weighted images which turns hyperintense on the T2 Weighted images within the medial right temporal lobe (se/im 104/8, 102/8) most likely represents partial voluming with the right temporal horn.
There is mild fullness of the third and both the lateral ventricles. Also seen is mild prominence of the basal cisternal spaces and cerebral cortical sulci bilaterally.
The fourth ventricle is normal. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Inflammatory changes are noted in the sphenoid sinus on the left side.
The MRI features are suggestive of a plaque-like lesion along the meninges just posterior to the clivus and extending upto the C2 vertebral level as described. The differential diagnosis would include :
1. Neoplastic processes like :
a. Small cell tumors.
c. En plaque meningioma.
2. Infective processes like tuberculosis.
A contrast enhanced study may be worthwhile.