Date : 00.00.00
Name of the Patient : Abc Xyzumar Mlmn / M / 65 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O right sided weakness with slurred speech and high blood pressure on 00.00.00 which has slightly improved.
Known 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 and Fast Scan (T2 *) coronal images.
There is a hyperintense area in the left thalamus on the T1 Weighted images which is seen to remain hyperintense on the proton, T2 Weighted and FLAIR images and represents extracellular methaemoglobin. There is slight extension into the left subthalamus with mild mass effect and indentation upon the body of the left lateral and the third ventricles.
An area of cystic encephalomalacia which is isointense to CSF on all the pulse sequences is seen in the left lentiform nucleus. The medial part of this lesion is seen to bloom on the Fast Scan (T2 *) images and is suggestive of deposition of paramagnetic substances.
There is fullness of both the lateral ventricles. The fourth ventricle is normal. Prominence of the cerebral cortical sulcal spaces is noted. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar system is ectatic. Calcification of the globus pallidus is noted bilaterally.
The MRI features are suggestive of :
1. A subacute haematoma in the left thalamus with mass effect as described, probably represents a primary hypertensive bleed.
2. An area of cystic encephalomalacia in the left lentiform nucleus.