Date : 00.00.00
Name of the Patient : Abc Xyzen lmn / F / 78 yrs.
Referred by : Dr. Abc Xyz Shah / Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O fall in the morning of 00.00.00 with loss of consciousness.
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 seen a diffuse, intermediate signal on the T1 Weighted images in the paramedullary cisterns, prepontine, interpeduncular, suprasellar and the middle cerebral artery cisterns. This lesion is masked on the T2 Weighted images but appears hyperintense on the FLAIR images. Similar signal is noted in the posterior fossa around the cerebellar hemispheres and in the posterior parietal sulcal spaces bilaterally. This lesion represents subarachnoid haemorrhage. Extension of the haemorrhage into the ventricular system, bilaterally is also noted with fluid level in the occipital horns bilaterally.
There are ill-defined hyperintense areas on the proton, T2 Weighted and FLAIR images in the periventricular white matter bilaterally and in the corona radiata and centrum semiovale. These lesions appear hypointense to normal white matter on the T1 Weighted images.
There is mild to moderate dilatation of both the lateral, third and fourth ventricles.
There is no shift of the midline structures.
1. Altered signal in the basal cisternal spaces as described represents subarachnoid haemorrhage. Intraventricular extension of the haemorrhage is also noted. An aneurysm should be ruled out.
2. Altered signal in the periventricular white matter and in the corona radiata and centrum semiovale most likely represents ischemic changes.
3. Mild to moderate dilatation of the ventricular system.