Date : 00.00.00
Name of the Patient : Abc Xyzankar Slmn / M / 62 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O pain and swelling over the left side of face with diminished vision on the left side, tinnitus and decreased hearing on the left side since 3 months.
H/O pulmonary kochs since 1 1/2 months. On AKT 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.
4 mm thick T1 Weighted and STIR coronal images.
5 mm thick T1 Weighted sagittal images.
MR cisternogram was obtained in the coronal plane.
There is no focal area of altered signal intensity in the brain parenchyma per se.
There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the left cavernous sinus, extending anteriorly upto the left orbital apex and extending inferiorly into the pterygopalatine fossa and via the pterygomaxillary fissure into the left infratemporal fossa. This lesion turns heterogeneously hyperintense (predominantly hypointense) on the T2 Weighted and STIR images. Hyperintense signal is however identified along the fat planes in the left infratemporal fossa, on the T2 Weighted and STIR images. The cavernous segment of the left internal carotid artery shows normal flow signal. The visualized left optic nerve also shows normal signal characteristics.
Inflammatory changes are noted in the left maxillary sinus, left anterior ethmoidal air cells and in the mastoid air cells on the left. The left inferior nasal turbinate is not well identified.
There is mild fullness of both the lateral and third ventricles. The fourth ventricle is normal. There is slight prominence of the cerebral cortical sulci and the cerebellar folia bilaterally.
The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
Small lymphnodes are noted in the upper cervical region deep to the sternocleidomastoid muscles bilaterally.
Altered signal intensity lesion in the left cavernous sinus, extending anteriorly upto the left orbital apex and inferiorly into the pterygopalatine fossa via the pterygomaxillary fissure into the left infratemporal fossa as described is not specific for a single etiology. This most likely is an inflammatory lesion. The possibility of a neoplastic lesion however cannot be entirely excluded.
Inflammatory changes are noted in the paranasal sinuses and left mastoid air cells as described.
A contrast enhanced scan would be worthwhile.