Date : 00.00.00
Name of the Patient : Abc Xyzai Vedalmn / F / 60 yrs.
Referred by : Dr. Abc Xyzagwati.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O giddiness with fall on 00.00.00 with loss of consciousness and left sided hemiplegia since then.
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.
There is a diffuse, hyperintense signal on the proton and T2 Weighted images involving the cortex and subcortical white matter in the right fronto-temporo-parietal region and in the right lentiform nucleus and head of right caudate nucleus. This lesion appears hypointense to normal white matter on the T1 Weighted images. There is resultant effacement of the sulcal spaces in the right fronto-temporo-parietal region with compression of the right lateral ventricle and mild bulge of the midline structures
to the left. There is no obvious haemorrhage in the right fronto-temporo-parietal region on this study.
There is a very small, approximately 0.5 cm diameter sized hyperintense focus on all the pulse sequences in the precentral gyrus. No perilesional edema or mass effect is noted (scans 104.16, 103.16, 105.7).
There is mild dilatation of the left lateral ventricle. The third and the fourth ventricles are normal. There is prominence of the cerebral cortical sulci on the left and the basal cisternal spaces. The petrous and cavernous segments of the right internal carotid artery do not show the normal flow void signal.
1. Altered signal involving the cortex and subcortical white matter in the right fronto-temporo-parietal region and in the right lentiform nucleus and head of right caudate nucleus represents a recent infarct in the distribution of the right ACA and MCA territories.
2. Loss of normal flow in the petrous and cavernous segments of the right internal carotid artery may suggest slow flow/thrombus.
3. Altered signal intensity lesion in the left precentral sulcus as described is not specific for a single etiology. This lesion may represent a calcific focus or deposition of paramagnetic substances.