Date : 00.00.00
Name of the Patient : Abc XyzMlmn / M / 35 yrs.
Referred by : Dr. Abc Xyzrnad.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
C/O sudden onset of facial asymmetry, deviation of both eyes towards right and diminished vision of the left eye and gait imbalance since 00.00.00.
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 FLAIR coronal images.
3 mm thick STIR coronal images.
5 mm thick T1 Weighted sagittal images.
There is a hyperintense focus located in the midbrain anterior to the aqueduct of sylvius (scans 103.7, 104.9) on the proton, T2 Weighted and FLAIR images. Another similar focus is seen in the pons anterior to the fourth ventricle (scans 103.5, 102.5).
Prominent perivascular space is seen in the lentiform nuclei bilaterally.
The left internal carotid artery appears smaller in diameter as compared to the opposite side.
The optic nerves show normal signal intensity on the STIR images bilaterally. The cavernous sinuses are unremarkable.
Both the lateral and third ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. The vertebro-basilar artery is ectatic.
Incidental note is made of right maxillary polyp.
1. Hyperintense foci in the midbrain anterior to the aqueduct and in the pons anterior to the fourth ventricle are most likely ischemic in etiology. The possibility of demyelination seems unlikely.
2. Narrowing of the left internal carotid artery requires further evaluation.
An MRA would be worthwhile.