Date : 00.00.00
Name of the Patient : Abc XyzK. Vlmn / M / 75 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O weakness of the RUE since 2 days.
Known diabetic/hypertensive. On Rx.
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.
There is evidence of gyral thickening in the left frontal lobe. These gyri are hypointense on the T1 Weighted images and turn hyperintense on the proton, T2 Weighted and FLAIR images. These lesions would represent recent areas of ischemia/infarction. A smaller area of similar signal alteration is seen in the left parietal lobe.
There are areas which are isointense to CSF on all the pulse sequences within the right parietal lobe. These are surrounded by areas of hypointensity on the T1 Weighted images and which turn hyperintense on the proton, T2 Weighted and FLAIR images and would represent gliotic changes. This lesion in toto would represent an area of cystic encephalomalacia. Ex-vacuo dilatation of the trigone of the right lateral ventricle is noted.
There is a hyperintense focus on the proton and T2 Weighted images in the pons and is most likely ischemic in etiology. Similar areas are also noted in the periatrial white matter bilaterally.
The normal flow-void signal is not seen within the intracranial left carotid artery and this may suggest slow flow/thrombus.
There is fullness of the third and both the lateral ventricles. Also seen is mild prominence of the cerebral cortical sulci and cerebellar folia bilaterally.
The fourth ventricle is normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures.
Incidental note is made of inflammatory changes in the ethmoidal air cells and sphenoid sinus.
The MRI features are suggestive of :
1. Altered signal in the left frontal lobe and in the left parietal lobe would represent recent areas of ischemia/infarction.
2. An area of cystic encephalomalacia in the right parietal lobe as described.
3. Slow flow/thrombus in the left internal carotid artery.
A MRA/DSA would be worthwhile.