Date : 00.00.00
Name of the Patient : Abc Xyz S. Plmn / F / 29 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.
CLINICAL PROFILE :
H/O fever, headaches and vomiting for 2 days on 00.00.00.
C/O paresthesias in BLE with involuntary movements of the LUE and RLE and on the left side of the face 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.
5 mm thick FLAIR coronal images.
3 mm thick T2 Weighted coronal images.
There is evidence of gyral thickening in the left frontal lobe. The cortical grey matter and subcortical white matter in this region is hyperintense on the proton, T2 Weighted and FLAIR images and hypointense on the T1 Weighted images. There is effacement of the adjacent cerebral cortical sulci (scans 103.13, 106.16, 102.13, 105.17).
Smaller foci with similar signal characteristics are noted at the grey-white matter junction in the left fronto-parietal lobes (scans 106.4, 106.8-10, 106.14), right fronto-parietal region and right lentiform nucleus (scans 106.11, 106.8-10).
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The MRI features are suggestive of :
1. An area of altered signal intensity with gyral thickening within the left frontal lobe is not specific for a single etiology. This may be ischemic in etiology or represent an evolving granuloma. This is less likely to represent a neoplastic process.
2. Foci of altered signal intensity within the grey-white matter junction in both the fronto-parietal lobes are also not specific for a single diagnosis. These may be ischemic in etiology or represent granulomas.
A contrast enhanced scan is essential.