Date : 00.00.00
Name of the Patient : Abc Xyzlmn / F / 53 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O severe headaches with vomiting and altered sensorium since 1 day.
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 and Fast Scan (T2 *) coronal images.
5 mm thick T1 Weighted sagittal images.
There is an intermediate signal intensity within the prepontine, interpeduncular Sylvian and the suprasellar cisterns on the T1 Weighted images which is seen to turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images but heterogeneously hypointense on the Fast Scan (T2 *) coronal images and would represent altered blood in the basal cisterns.
There is thickening of the gyri in the inferior frontal parafalcine regions bilaterally, which appear hypointense to the normal gray matter on the T1 Weighted images and turn heterogeneously hyperintense on the proton, T2 Weighted and FLAIR images.
There is slight fullness of both the lateral ventricles with a fluid level in the occipital horns bilaterally.
The third and the fourth ventricles are normal. There is no shift of the midline structures.
1. Altered signal within the prepontine, interpeduncular, Sylvian and the suprasellar cisterns would represent altered blood suggesting subarachnoid haemorrhage.
2. Altered signal in the inferior frontal-parafalcine regions bilaterally represent a recent ischemic lesion.
Distribution of the ischemic lesions and subarachnoid and intraventricular haemorrhage as described above may suggest a ruptured aneurysm in the anterior circulation.