Date : 00.00.00
Name of the Patient : Abc Xyzarayan Jalmn / M / 53 yrs.
Referred by : Dr. Abc Xyzgaonkar Dr. Abc Xyzhan.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O sudden onset of vision loss since 1 week.
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.
3 mm thick STIR coronal images through the optic nerves.
There are hyperintense areas in the occipital lobes bilaterally and the right cerebellar hemisphere on the proton, T2 Weighted and FLAIR images. These are isointense to the grey matter on the T1 Weighted images. There is involvement of the cortex as well as the subcortical white matter. Subtle hyperintense signal is seen on the T1 Weighted images which is seen to remain hyperintense on the T2 Weighted images and would represent extracellular methemoglobin/paramagnetic substances (better appreciated on the sagittal images).
The right vertebral artery appears narrow (se/im 102/4, 103/11, 104/4, 105/4) and does not show its normal flow void signal suggestive of slow flow/thrombus.
Dilated perivascular spaces are seen in the centrum semiovale bilaterally.
The optic nerves bilaterally show normal signal intensity.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
1. Infarcts in the occipital lobes bilaterally with a haemorrhagic component and in the right cerebellar hemisphere.
2. Slow flow/thrombus in the right vertebral artery.
A MRA/DSA would be worthwhile.